Hearing Impairment in Infants with Hypoxic Ischemic Encephalopathy Treated with Hypothermia.

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  • Additional Information
    • Source:
      Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 101543518 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2153-7933 (Electronic) Linking ISSN: 21537658 NLM ISO Abbreviation: Ther Hypothermia Temp Manag Subsets: MEDLINE
    • Publication Information:
      Original Publication: New Rochelle, NY : Mary Ann Liebert, Inc.
    • Subject Terms:
      Hearing Loss*/diagnosis ; Hearing Loss*/etiology ; Hearing Loss*/therapy ; Hypothermia, Induced*/adverse effects ; Hypoxia-Ischemia, Brain*/complications ; Hypoxia-Ischemia, Brain*/diagnosis ; Hypoxia-Ischemia, Brain*/therapy; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Retrospective Studies
    • Abstract:
      Therapeutic hypothermia acts as the standard of care for infants with moderate to severe hypoxic ischemic encephalopathy (HIE). A proportion of neonates who undergo hypothermia due to HIE have shown to develop various degrees of hearing impairment. Analyzing and identifying infants at high risk of developing hearing difficulties is fundamental for early intervention of such auditory complications. The aim was to assess clinical factors in the development of hearing impairment following therapeutic hypothermia in HIE infants. A retrospective analysis was performed on infants hospitalized in our neonatology department in Poznan University of Medical Sciences, Poland. All infants experienced moderate to severe HIE, and were treated with therapeutic hypothermia. Risk factors for hearing impairment were identified in all infants included in the study. Clinical data during hospital stay and follow-up hearing status were analyzed. A total of 87 HIE infants were included in the study. Seventy-six infants (40 male and 36 female) had otoacoustic emission (OAE) examination following birth, of which 14 (18.4%) demonstrated abnormal (positive) results. Infants with abnormal OAE results had significantly lower blood pH (6.86 ± 0.16, p  = 0.001) and base excess (BE) (-22.46 ± 2.59, p  = 0.006). Of the 49 infants who returned for follow-up assessment, 4 (8.2%) were diagnosed with sensorineural bilateral hearing impairment (1 infant, mild [<40 dB], 2 moderate [41-70 dB], and 1 profound [>90 dB]). The biochemical analysis following birth revealed significantly lower umbilical BE levels (-23.90 ± 4.99, p  = 0.041) and higher lactate levels (160.67 ± 4.93, p  = 0.019) in the infants with eventual sensorineural hearing deficit. Infants with moderate or severe HIE are at risk of delayed onset hearing loss. Diligent efforts to monitor auditory status are required, even if early screening results for hearing are insignificant. Exploring biochemical parameters, such as lactate, BE, and blood pH, can prove beneficial in identifying HIE infants at risk of developing a hearing impairment.
    • Contributed Indexing:
      Keywords: hearing impairment; hypothermia; hypoxic ischemic encephalopathy; neonates
    • Publication Date:
      Date Created: 20210129 Date Completed: 20220309 Latest Revision: 20220531
    • Publication Date:
      20240104
    • Accession Number:
      10.1089/ther.2020.0043
    • Accession Number:
      33512300