Relation between predischarge auditory brainstem responses and clinical factors in high-risk infants.

BACKGROUND

Advances in perinatal medicine have increased the survival rate of infants admitted to neonatal intensive care units (NICU). Some of the infants will have health problems including hearing disorder and/or brainstem dysfunction, and may have associated communicative and cognitive difficulties and/or repeated apnea attacks that require therapy or care.

METHODS

In this study, the authors measured mean thresholds and mean I-V interpeak latencies in 56 high-risk infants and 30 controls who were about to be discharged from NICU. The authors retrospectively investigated whether predischarge auditory brainstem response (ABR) data, which seem to be related to a number of clinical factors affecting neonates, are useful for detecting hearing disorder and/or brainstem dysfunction, and we investigated six clinical factors.

RESULTS

The results showed that the positive risk factors for hearing impairment in infants who are about to be discharged from the NICU are: receiving mechanical ventilation (including for a period of <1 day) and the administration of five or more different antibiotics, especially in extremely low-birthweight (ELBW) infants. Another result showed that the high-risk mature infants had a significant high risk factor for brainstem dysfunction.

CONCLUSIONS

The findings of the study emphasize the importance of performing ABR examinations in high-risk infants, even in infants who are about to be discharged from an NICU. ABR examinations are especially important in ELBW infants or mature infants who have received mechanical ventilation or who have received five or more different antibiotics.