Kaushik Ramya, Reed Nicholas, Ferrante Lauren E
Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Optimal Aging Institute, NYU Grossman School of Medicine, New York, NY.
Crit Care Explor. 2025 Mar 3;7(3):e1223. doi: 10.1097/CCE.0000000000001223. eCollection 2025 Mar 1.
Hearing impairment is associated with delirium among ICU patients and a lack of functional recovery among older ICU survivors. We assessed the feasibility of using otoacoustic emissions (OAEs) testing to screen for preexisting hearing loss in the ICU.
Pilot study.
Medical ICU at a tertiary medical center.
All adults (age ≥ 18) and admitted to the medical ICU between November 29, 2021, and December 03, 2021, were eligible for the study.
OAE is a noninvasive, nonparticipatory tool that is used to screen for hearing loss by detecting intracochlear motion in response to auditory stimulation. The presence or absence of OAE was tested at six frequencies (1 k, 1.5 k, 2 k, 3 k, 4 k hertz).
The primary outcome of feasibility was defined a priori as completion of greater than or equal to 70% of attempted tests. Average time of test completion and barriers or facilitators were also measured as outcomes. A patient passed OAE testing if at least two of six frequencies were detected in at least one ear, suggesting they did not have moderate or severe hearing impairment (that would require an amplifier). Data were also gathered on demographics, delirium, ventilation, sedation, illness severity, and ambient noise. Of 31 patients approached, 23 (74.2%) underwent testing. Eight patients (25.8%) were unable to be tested, most commonly due to elevated ambient noise. Among the 18 patients with complete data, six patients screened positive for hearing loss. The average time for OAE test completion per ear was 152.6 seconds (sd = 97.6 s).
OAE testing is a feasible method to screen for hearing loss in the ICU, including in nonparticipatory patients. Identification of hearing loss would facilitate improved communication through interventions such as amplifiers and accommodations. Future studies should evaluate whether identification and treatment of hearing loss in the ICU may reduce delirium and improve post-ICU recovery.
听力障碍与重症监护病房（ICU）患者的谵妄以及老年ICU幸存者功能恢复不佳有关。我们评估了使用耳声发射（OAE）测试在ICU中筛查既往存在的听力损失的可行性。
前瞻性研究。
一家三级医疗中心的内科ICU。
2021年11月29日至2021年12月3日期间入住内科ICU的所有成年人（年龄≥18岁）均符合研究条件。
OAE是一种非侵入性、无需患者配合的工具，用于通过检测对听觉刺激的耳蜗内运动来筛查听力损失。在六个频率（1千赫、1.5千赫、2千赫、3千赫、4千赫）下测试是否存在OAE。
可行性的主要结局预先定义为完成至少70%的尝试测试。测试完成的平均时间以及障碍或促进因素也作为结局进行测量。如果至少一只耳朵在六个频率中的至少两个频率检测到OAE，则患者通过OAE测试，这表明他们没有中度或重度听力障碍（这需要放大器）。还收集了有关人口统计学、谵妄、通气、镇静、疾病严重程度和环境噪声的数据。在31名符合条件的患者中，23名（74.2%）接受了测试。8名患者（25.8%）无法进行测试，最常见的原因是环境噪声过高。在18名有完整数据的患者中，6名患者听力损失筛查呈阳性。每只耳朵完成OAE测试的平均时间为152.6秒（标准差=97.6秒）。
OAE测试是在ICU中筛查听力损失的一种可行方法，包括对不配合的患者。识别听力损失将有助于通过放大器和调整等干预措施改善沟通。未来的研究应评估在ICU中识别和治疗听力损失是否可以减少谵妄并改善ICU后的恢复情况。
