[Hearing loss following discharge from the NICU]

We experienced 10 pediatric cases born between November of 1988 and November of 1992, whose ABR were normal at the time of discharge from the NICU, who subsequently developed hearing impairment. These children underwent thorough evaluations and the causes of their hearing loss are discussed herein. All 10 were born at full term, birth weights ranged from 2500g to 3826g, and all had severe cardiovascular and/or pulmonary disorders. Eight of the 10 had persistent pulmonary hypertension of the newborn (PPHN). During the four year period in which these 10 infants were born, a total of 25 PPHN cases were diagnosed in our NICU, i.e. the rate of hearing loss in PPHN infants was 32% (8/25). All 10 infants were intubated and maintained on mechanical ventilation for an average of 30 days. Five cases also required high frequency oscillation and six received extracorporeal membrane oxygenation (ECMO). During the same time period there were only eight surviving ECMO cases such that the rate of hearing loss was 75% (6/8). All 10 were treated with an aminoglycoside, furosemide and a muscle relaxant. As These infants are at very high risk for hearing impairment, follow-up at 6 and 12 months of age is essential.