单人家庭病房新生儿重症监护病房听力筛查失败的风险因素。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2024-11-25 DOI:10.1055/a-2483-5788

Rebecca Suflas, Rebecca Cox, Rose M Viscardi, Jocelyn Leung

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引用次数: 0

摘要

目的：确定听力筛查结果，并识别导致极早产儿听力筛查失败的临床和环境因素：确定听力筛查结果，并识别在四级单人家庭病房（SFR）新生儿重症监护病房（NICU）中极早产儿听力筛查失败的临床和环境风险因素：研究设计：我们对婴儿进行了一项回顾性研究：在 425 名有听力筛查结果记录的合格婴儿中，353 人（83%）通过了听力筛查，72 人（17%）未通过听力筛查[单侧，44 人（61%）；双侧，28 人（39%）]。与通过听力筛查的婴儿相比，听力筛查失败的婴儿胎龄和出生体重较低，性别为男性，产后和月经后接受筛查的时间较晚，1 分钟和 5 分钟 Apgar 评分较低，呋塞米治疗时间较长，早期低血压，IVH≥ 3 级，在 PMA 36 周时出现 BPD。听力筛查失败的婴儿需要更长时间的有创和无创呼吸支持。双侧听力筛查未通过的婴儿（18.4±18.4 d）与听力筛查通过的婴儿（7.4±12.8 d）和单侧听力筛查未通过的婴儿（9±13 d）相比，加热、加湿、高流量鼻插管>2LPM的暴露时间明显更长（平均值±标度，p）：我们推测，BPD 与听力筛查失败之间的关联可能部分是由长期噪音暴露（包括呼吸辅助设备产生的噪音）引起的。在呼吸支持过程中注意保护高危婴儿的听力可能会降低听力损失的风险。

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Risk Factors for Hearing Screen Failure in a Single Family Room Neonatal Intensive Care Unit.

Objective: To determine hearing screen outcomes and identify clinical and environmental risk factors for hearing screen failure in very preterm infants at a level IV single family room (SFR) neonatal intensive care unit (NICU).

Study design: We conducted a retrospective study of infants <33wks gestational age admitted to a level IV SFR NICU who survived to discharge and had automated auditory brainstem response results available. Demographics, antenatal and postnatal factors, and respiratory support modes and their duration were collected from the electronic medical record.

Results: Of 425 eligible infants with documented hearing screen results, 353 (83%) passed and 72 (17%) failed the hearing screen [unilateral, N= 44 (61%); bilateral, N= 28 (39%)]. Compared to infants who passed the hearing screen, infants with hearing screen failure were lower gestational age and birthweight, male sex, were screened at later postnatal and postmenstrual ages, had lower 1 and 5 min Apgar scores, longer duration of furosemide therapy, early hypotension, IVH≥ Grade 3, and BPD at 36 weeks PMA. Infants with hearing screen failure experienced longer exposures to invasive and non-invasive respiratory support. Heated, humidified, high flow nasal cannula >2LPM exposure was significantly longer in infants with bilateral hearing screen failure (18.4±18.4 d) compared to duration in infants who passed (7.4±12.8 d) and those with unilateral failure (9±13 d), (mean ± SD, p<0.001). In the final logistic model, IVH ≥Grade 3 (OR 3.22, 95% CI 1.15-8.98, p=0.026) and BPD (OR 2.27, 95% CI 1.25-4.11, p=0.007) were the factors with greatest risk for hearing screen failure.

Conclusion: We speculate that the association of BPD with hearing screen failure may be mediated, in part, by chronic noise exposure, including from respiratory support devices. Attention to hearing protection in at-risk infants during respiratory support may mitigate the risk of hearing loss.

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.