الفهرس 
Auditory brain stem response (abr) in neonates with indirect hyperbilirubinemia after exchange transfusion
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Abstract
eonatal hyperbilirubinemia is a common clinical condition seen during the neonatal period, especially in the first week of life.It is characterized by yellowish discoloration of the skin of the neonate.
It is firstly noted in the face and when the bilirubin level rises, it proceeds to the body and then to the extremities.
It can take a simple course without problems or can be serious causing severe neurological deficits.
The treatment options for jaundice include phototherapy, exchange transfusion and pharmacological treatment as intravenous immunoglobulins (IVIG).
Our cross sectional analytical study was carried out in the Neonatal intensive care units of Abu El-Resh hospital Cairo University to detect hearing impairment in neonates with severe indirect hyperbilirubinemia after exchange transfusion.
Results of our study showed that hearing impairment occurred in 32.6% of cases who underwent exchange transfusion after severe hyperbilirubinemia.
This percentage is not due to exchange transfusion but it is an association with severe hyperbilirubinemia necessitating exchange transfusion especially when there is BIND score affection.
Our study revealed a significant relation between age of onset of jaundice in days and hearing impairment. Neonates with hearing impairment have a median of 2 with minimum 1 and maximum 21 days.
Also there was a significant relation between level of total bilirubin before exchange and hearing impairment. Neonates who showed hearing impairment with high bilirubin level before exchange have a median of 30 with minimum 10.4 and maximum 45.9 and Cut off point was 22.35 mg/dl.
Also there was a significant relation between BIND score and hearing impairment. Neonates who showed hearing impairment with BIND score affection have a median of 3 with minimum 0 and maximum 8 and Cut off point was 1.5.
We conclude that: neonates with severe indirect hyperbilirubinemia necessitating exchange transfusion especially with BIND score affection are more liable for hearing impairment and need to be followed up in audiology department for further assessment and management.