Abstract
Neonatal bilirubin toxicity (kernicterus) frequently results in deafness. The auditory brainstem response (ABR) has used as a hearing screening tool for newborns. We studied the potential usefulness of the ABR for detecting neonatal bilirubin toxicity using a rhesus monkey infant model.
Five rhesus monkey infants aged 1,6,20, 35, and 40 days received up to 300 mg/kg of intravenous bilirubin over four hours with ABR monitoring. The one day old infant was a non-asphyxiated premature with hyaline membrane disease. If no bilirubin induced ABR change occurred, sulfisoxazole (200 mg/kg), a bilirubin displacer with no effect on the ABR, was given. Progressive ABR flattening was observed in the premature (bilirubin only) and in the 6 day old (bilirubin and sulfisoxzole). The total bilirubin concentrations at the time of ABR flattening were 33 and 60 mg% for the premature and 6 day old, respectively. The ABR in the 6 day old partially recovered in 24 hours. However, the Wave I-V latency had increased from 3.31 msec initially to 3.75 msec and the I/V amplitude ratio decreased from 2.0 to 0.7. No yellow staining was found in the brains of these two animals. No bilirubin induced ABR changes occurred in the 3 older animals.
The auditory evoked response may be a sensitive, early indicator of reversible bilirubin toxicity, and the infant rhesus monkey may be a useful paradigm for studying bilirubin toxicity.
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Ahlfors, C., Shoemaker, C., Bennett, S. et al. BILIRUBIN ASSOCIATED ABNORMALITIES OF THE AUDITORY BRAINSTEM RESPONSE IN AN INFANT RHESUS MONKEY MODEL. Pediatr Res 18 (Suppl 4), 308 (1984). https://doi.org/10.1203/00006450-198404001-01292
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DOI: https://doi.org/10.1203/00006450-198404001-01292