Delayed post-neonatal intensive care unit hearing disturbance.

Ten children, who developed hearing disturbance after discharge from the neonatal intensive care unit (NICU), are reported. All were born at full term, between November 1988 and November 1992, weighed at least 2500 g and had normal auditory brainstem response (ABR) at discharge from the NICU. All ten underwent thorough evaluation to determine the cause of the subsequent hearing loss. All had severe cardiovascular and/or pulmonary disorders at birth, and persistent pulmonary hypertension of the newborn (PPHN) was diagnosed in eight. A total of 25 PPHN cases were treated at our facility during the 1988-1992 period, the rate of hearing disturbance in PPHN patients being 32%. The 10 infants in this study were mechanically ventilated for, on average, 30 days. High frequency oxygenation (HFO) was required in five cases, extra corporeal membrane oxygenation (ECMO) in six. During this period, only eight ECMO-treated infants survived. The rate of hearing loss in surviving cases was therefore very high, 75% (6 8). All 10 of our cases were treated with an aminoglycoside, furosemide and a muscle relaxant. We recommend follow-up at 6 and 12 months of age, as these children are at very high risk of developing hearing disturbance.