Hyponatremia and Sensorineural Hearing Loss in Preterm Infants

Abstract

In a case-control study the role of hyponatremia in the hearing loss of preterm infants was investigated. One hundred and sixty-four premature infants treated at the neonatal intensive care unit were screened with transient evoked otoacoustic emission (TEAOE). In 32 infants TEAOE results indicated the need for further investigations. Auditory brainstem response was performed and 22 of 32 cases had bilateral hearing impairment (HI). The birth weight and gestational age in the HI group were 1,425 ± 528 g and 30.4 ± 3.7 weeks. The matched control group consisted of 25 infants with a mean birth weight and gestational age of 1,410 ± 280 g and 31.1 ± 2.1 weeks. Significant differences were found between the HI and control groups: Apgar score (p < 0.05), pH value (p < 0.01) and pO₂ level (p < 0.05) were lower; the total dose of aminoglycosides (p < 0.01), furosemide usage (p < 0.01), the maximum pCO₂ level (p < 0.01), incubator stay (p < 0.05) and hyponatremia (p < 0.01) were higher, and the duration of hyponatremia (p < 0.05) was longer in the HI group. Multivariate logistic regression revealed that aminoglycoside treatment and hyponatremia were the two most significant factors in the development of hearing impairment. These results suggest that hyponatraemia is an additional risk factor for hearing loss in preterm infants.

Sensorineural hearing loss at 9-13 years of age in children with a history of neonatal extracorporeal membrane oxygenation

“…Exposure to ototoxic drugs such as aminoglycosides and loop diuretics has also been associated with hearing loss in neonates that received ECMO support 17 25. In our study, we found an association between SNHL and pre-ECMO exposure to furosemide.…”

“…In fact, 100% of infants with SNHL in this study had pre-ECMO Paco 2 levels less than 30 mm Hg before the initiation of ECMO support. Findings of hypocapnia in association with SNHL in the neonatal ECMO population have also been shown by other investigators 19 25. Indeed, current recommendations for the ventilation of critically ill hypoxic infants with underlying conditions such as meconium aspiration syndrome (MAS), congenital diaphragmatic hernia (CDH) or pulmonary hypertension of the newborn (PPHN) call for keeping Paco 2 levels within the normal range to prevent untoward neurological outcomes.…”

Diagnosis of Acute Renal Failure in Very Preterm Infants

“…Recent clinical and experimental studies were focused on neurological consequences of neonatal hyponatremia even if hyponatremia due to sodium losses has been studied more than hyponatremia due to hemodilution [8]. Deafness [15][16][17], cerebral palsy [18] and alterations in cognitive performances [19] have been recorded. Pontine myelinolysis following rapid correction of a chronic hyponatremia also remains a putative complication in neonates [20].…”

Study of biochemical abnormalities in neonatal seizures with special reference to hyponatremia

“…Hyponatremia, besides causing seizures, is also known to result in adverse neurological developmental outcomes like increased risk of cerebral palsy and increased risk of hearing loss. 4 The present study aims to explore the incidence of hyponatremia in neonatal seizures and to study the clinical profile of neonatal seizures with hyponatremia.…”