Improvement inauditory andvisual evoked potentials inj'aundiced preterminfants after exchange transfusion

SUMMARY Two preterm infants with peak serum bilirubin concentrations of 270 imol/l and200 [tmol/l, respectively showed improvement in the wave peak latencies of the auditory andvisual evokedpotentials after exchangetransfusion. Theimplications ofthis observation andthe use of evoked potential recording in neonatal jaundice are discussed. Thereis uncertainty amongneonatologists ofwhat a safe serum bilirubin concentration should be in a small preterm infant.1-3 This uncertainty has re- sulted from the lack of an objective method to evaluate the acute cerebral effects of hyperbilirubi- naemia. The measurement of auditory brain stem response is a useful clinical tool to monitor theeffects, albeit transient, of acute hyperbilirubi- naemia in full term infants.4 Auditory brain stem responses of jaundiced preterm infants have not been studied and visual evoked potentials have not been reported in jaundiced neonates. Wereport the changesin the auditory brain stem response andvisual evokedpotentialin