title: The effects of aggressive vs. conservative phototherapy on the brainstem auditory evoked responses of extremely-low-birth-weight infants.
abstract: BACKGROUND
  This study was a two-center, stratified, parallel-group randomized trial comparing the effects of aggressive vs. conservative phototherapy on brainstem auditory evoked response (BAER) latencies in infants with extremely low birth weight (ELBW, ≤ 1,000 g).
  
  
  RESULTS
  BAER latencies of 751-1,000 g birth-weight infants were shorter by 0.37 ms (95% confidence interval (CI) = 0.02, 0.73) for wave V, 0.39 ms (0.08, 0.70) for wave III, and 0.33 ms (0.01, 0.65) for wave I after aggressive phototherapy at one center. Interwave intervals did not differ significantly. Similar nonsignificant trends were recorded for 501-750 g birth-weight infants. At the other participating center, no significant differences were recorded, cautioning against overgeneralizing these results.
  
  
  CONCLUSIONS
  The effects of bilirubin on the auditory pathway in ELBW infants depend on a complex interaction of bilirubin exposure, newborn characteristics, and clinical management.
  
  
  METHODS
  Aggressive phototherapy was initiated sooner and continued at lower bilirubin levels than conservative phototherapy. A total of 174 ELBW infants were enrolled in the study; 111 infants were successfully tested at 35 weeks postmenstrual age (PMA); 57 died; and 6 were not successfully tested.
authors.affiliation: Center for Clinical Research and Evidence-Based Medicine, University of Texas Medical School at Houston, Houston, Texas, USA. Robert.E.Lasky@uth.tmc.edu
authors.forename: Robert E
authors.initials: RE
authors.lastname: Lasky
authors.forename: Michael W
authors.initials: MW
authors.lastname: Church
authors.forename: Mark S
authors.initials: MS
authors.lastname: Orlando
authors.forename: Brenda H
authors.initials: BH
authors.lastname: Morris
authors.forename: Nehal A
authors.initials: NA
authors.lastname: Parikh
authors.forename: Jon E
authors.initials: JE
authors.lastname: Tyson
authors.forename: Georgia E
authors.initials: GE
authors.lastname: McDavid
authors.forename: William
authors.initials: W
authors.lastname: Oh
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
authors.forename: Ronnie
authors.initials: R
authors.lastname: Guillet
authors.forename: Dale L
authors.initials: DL
authors.lastname: Phelps
mesh_terms: D001663:Bilirubin / Q000528:radiation effects; D001724:Birth Weight; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male; D010789:Phototherapy / Q000379:methods*; D011930:Reaction Time / Q000502:physiology*
chemical_list: D001663:Bilirubin