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[Long-term results of a hearing screening in critically ill patients dismissed from an intensive care unit]
F Cavaliere1, S Masieri, A Arcangeli
1Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Roma.
Aim:
To evaluate the auditive function of a group of critical patients after discharge from an ICU.
Design:
An audiological screening was carried out 90-120 days after discharge.
Patients:
Eighteen patients, that had been admitted to a polyvalent ICU for head injury, stroke or complicated neurosurgical procedures. They had all been in a coma.
Interventions:
all the patients had undergone orotracheal intubation and mechanical ventilation lasting more than a week as well as ototoxic drugs (aminoglycosides and furosemide) administration. Antibiotic plasma levels had been monitored.
Measurements And Results:
At examination, only 7 subjects were aware of being hypoacusic; no other symptom was reported. However audiometry and impedentiometry revealed the presence of mono or bilateral middle ear effusion in 11 subjects (61%) and high frequency neurosensorial hypoacusia in 2 cases (11%). Human voice frequencies were poorly affected by both transmissive and neurosensorial damages so that subjects did not report any hearing loss.
Conclusions:
Neurosensorial hypoacusia was probably caused by amynoglycoside toxicity in spite of blood level monitoring; ABR could be effective in preventing toxic damage by detecting early hearing impairment. Middle ear effusion occurrence is difficult to be prevented but appropriate medical therapy is usually effective after the recovery from coma.