title: Bilateral sensory permanent hearing loss after palliative hypoplastic left heart syndrome operation.
abstract: BACKGROUND
  Bilateral sensory permanent hearing loss (PHL) has been reported after neonatal respiratory failure but has rarely been noted in survivors after cardiac operations. We report the prevalence and severity of PHL after Norwood right ventricular-pulmonary artery shunt for hypoplastic left heart syndrome (HLHS), document progressive loss, and explore markers of acute illness and ototoxic medications for PHL.
  
  
  METHODS
  This interprovincial longitudinal outcome study after neonatal complex cardiac operations at Stollery Children's Hospital, Edmonton, Alberta, Canada, 2002 to 2007, completed repeated diagnostic audiologic assessments for all survivors by registered pediatric-experienced audiologists. Demographic, surgical, and perisurgical variables, including ototoxic medications, were collected. The association of potentially predictive variables with PHL and its severity were determined by univariate analysis and multiple logistic and linear regression analysis.
  
  
  RESULTS
  At an age older than 3.5 years, progressive PHL was present in 12 of 42 survivors (28.6%, 95% confidence interval, 16.2% to 44.8%; mortality, 20.9%). Overall lowest partial pressure of arterial oxygen (odds ratio, 1.315; 95% confidence interval, 1.051 to 1.506), and cumulative dose of furosemide given as bolus (odds ratio, 1.062; 95% confidence interval, 1.018 to 1.109) combined to predict PHL and gave 39% of the variance of PHL severity. Antibiotics and neuromuscular blockers were not associated with PHL.
  
  
  CONCLUSIONS
  Monitoring outcomes of neonates after HLHS surgery revealed unexpected PHL associated with hypoxia and bolus administration of furosemide. As survival improves, close follow-up is necessary to identify outcomes and seek modifiable predictive variables. Changes in the mode of furosemide administration may prevent this complication.
authors: Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Canada. charlene.robertson@albertahealthservices.ca
authors: Charlene M T
authors: CM
authors: Robertson
authors: Gwen Y
authors: GY
authors: Alton
authors: Karin T
authors: KT
authors: Bork
authors: Ari R
authors: AR
authors: Joffe
authors: Gerda C
authors: GC
authors: Tawfik
authors: Reg S
authors: RS
authors: Sauve
authors: Diane M
authors: DM
authors: Moddemann
authors: David B
authors: DB
authors: Ross
authors: Ivan M
authors: IM
authors: Rebeyka
mesh_terms: D001299:Audiometry; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects*; D005665:Furosemide / Q000008:administration & dosage / Q000009:adverse effects*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D000860:Hypoxia / Q000150:complications*; D007223:Infant; D007231:Infant, Newborn; D010166:Palliative Care
chemical_list: D004232:Diuretics; D005665:Furosemide