Ototoxic drugs and sensorineural hearing loss following severe neonatal respiratory failure

• Published in: Acta pædiatrica (Oslo) Vol. 95; no. 2; pp. 214 - 223
• Main Authors: ROBERTSON, Charlene M. T, TYEBKHAN, Juzer M, PELIOWSKI, Abraham, ETCHES, Philip C, CHEUNG, Po-Yin
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01.02.2006
• Subjects: Amikacin - adverse effects; Amikacin - therapeutic use; Aminoglycosides - adverse effects; Aminoglycosides - therapeutic use; Anti-Infective Agents - adverse effects; Anti-Infective Agents - therapeutic use; Audiometry, Pure-Tone - methods; Auditory Threshold - physiology; Biological and medical sciences; Diuretics - adverse effects; Diuretics - therapeutic use; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Ethacrynic Acid - adverse effects; Ethacrynic Acid - therapeutic use; Female; Furosemide - adverse effects; Furosemide - therapeutic use; General aspects; Gentamicins - adverse effects; Gentamicins - therapeutic use; Hearing Loss, Sensorineural - chemically induced; Hearing Loss, Sensorineural - diagnosis; Humans; Infant, Newborn; Male; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pancuronium - adverse effects; Pancuronium - therapeutic use; Pneumology; Respiratory Insufficiency - diagnosis; Respiratory Insufficiency - drug therapy; Respiratory Insufficiency - physiopathology; Respiratory system : syndromes and miscellaneous diseases; Severity of Illness Index; Tobramycin - adverse effects; Tobramycin - therapeutic use; Vancomycin - adverse effects; Vancomycin - therapeutic use; Vecuronium Bromide - adverse effects; Vecuronium Bromide - therapeutic use; Human; Drug; sensorineural hearing loss; Pediatrics; Neonatal; Respiratory disease; Internal ear disease; Auditory disorder; Newborn; ototoxic drugs; Respiratory failure; ENT disease; Perception hearing loss; Children; Severe; neonatal respiratory failure; Child; Sensory hearing loss
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1080/08035250500294098

To determine relationships between ototoxic drugs and 4-y sensorineural hearing loss (SNHL) in near-term and term survivors of severe neonatal respiratory failure. All 81 survivors of the Canadian arm of the Neonatal Inhaled Nitric Oxide Study (mortality 32, loss to follow-up 9) received loop diuretics, aminoglycosides, and neuromuscular blockers (NMB), and 50 received vancomycin as neonates. Prospective, longitudinal secondary outcome using audiological tests diagnosed late-onset, progressive SNHL in 43 (53%); not flat (sloping) in 29, flat (severe to profound) in 14. Risk for SNHL was determined. A combination of duration of diuretic use of >14 d and average NMB dose of >0.96 mg/kg/d contributed to SNHL among survivors (odds ratio 5.2; 95% CI 1.6, 16.7). Markers of illness severity did not contribute. Dosage or duration of aminoglycosides use did not relate to SNHL. Cumulative dosages and duration of use of diuretics; NMB; use of vancomycin; and overlap of diuretics with NMB, aminoglycosides, and vancomycin individually linked to SNHL (p<0.001). Overuse of loop diuretics and/or NMB contributes to SNHL after neonatal respiratory failure; markers of illness severity or the appropriate administration of aminoglycosides do not.