Hearing loss in survivors of neonatal extracorporeal membrane oxygenation (ECMO) therapy and high-frequency oscillatory (HFO) therapy.
Lasky RE. Wiorek L. Becker TR.
Neurology Department, The University of Wisconsin-Madison Medical School, 53792-5132, USA.
Survivors of extracorporeal membrane oxygenation (ECMO) therapy and high-frequency oscillatory (HFO) therapy during the newborn period were followed to evaluate their hearing. Eleven of the 66 ECMO survivors (16.7%) were diagnosed with significant hearing loss after being discharged from the neonatal intensive care unit (NICU). This rate of hearing loss is consistent with other reports of hearing loss in ECMO survivors. The majority of ECMO survivors with hearing loss developed a bilateral sloping hearing loss; the high frequencies were more impaired than the low frequencies. The hearing of nine ECMO survivors with hearing loss was assessed with auditory brainstem evoked responses (ABRs) in the newborn period prior to discharge from the NICU. Seven of nine ECMO survivors with hearing loss passed their newborn ABR screen. This result is consistent with the results of other researchers. Eight newborns receiving ECMO therapy had congenital diaphragmatic hernias (CDH). Three of these newborns (37.5%) were subsequently diagnosed as having a hearing loss. The combination of CDH and ECMO therapy may be a strong predictor of hearing loss. Six HFO survivors with hearing losses were also followed. Their losses were similar to the ECMO survivors with hearing loss, including the progressive nature of the loss (all five of these newborns with neonatal ABR screens passed them only to later be diagnosed with a hearing loss). A growing body of research indicates that newborns experiencing severe oxygen deprivation are at risk for progressive hearing loss.