Evaluation of Gentamicin Exposure in the Neonatal Intensive Care Unit and Hearing Function at Discharge.
Evaluation of Gentamicin Exposure in the Neonatal Intensive Care Unit and Hearing Function at Discharge.
复制标题
新生儿重症监护室庆大霉素暴露和出院时听力功能的评估。
DOI：
10.1016/j.jpeds.2018.07.101
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Hornik,ChristophP
中科院分区：
文献类型：
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作者：
Puia-Dumitrescu,Mihai;Bretzius,OliviaM;Brown,Nia;Fitz-Henley,JamesA;Ssengonzi,Rebecca;Wechsler,CarolineS;Gray,KeyariaD;BenjaminSr,DanielK;Smith,PBrian;Clark,ReeseH;Gonzalez,Daniel;Hornik,ChristophP
Objective描述庆大霉素剂量、治疗持续时间和耳毒性之间的相关性，研究设计在330个新生儿重症监护室（2002-2014年）进行的回顾性队列研究包括暴露于庆大霉素的先天性婴儿，并排除剂量数据不完整和主要先天性异常的婴儿。我们的主要结局是住院期间进行的最终听力筛查结果：异常（单耳或双耳失败或需要进一步测试）或正常（双耳通过）。庆大霉素暴露的4个指标为最高日剂量、平均日剂量、累积剂量和累积暴露持续时间。我们拟合单独的多变量logistic回归模型调整人口统计学，合并症，和其他临床events.ResultsA共84 808婴儿符合纳入/排除标准;中位数（第25，第75百分位）胎龄和出生体重分别为35周（33，38）和2480克（1890，3184）。3238例（3.8%）婴儿听力筛查失败;筛查失败更可能发生在胎龄和出生体重较低的婴儿中，这些婴儿住院时间较长，发病率较高，胎龄较小。中位最高日剂量、平均日剂量和累积剂量分别为4.0 mg/kg/天（3.0，4.0）、3.8 mg/kg/天（3.0，4.0）和12.1 mg/kg（9.1，20.5）。中位累积暴露持续时间为3天（3，6）。在调整后的分析，庆大霉素剂量和治疗的持续时间与听力屏幕failure.ConclusionsGentamicin剂量和治疗的持续时间与失败的听力屏幕在出院时，从最初的新生儿重症监护病房住院的几率增加不相关。
ObjectiveTo characterize the association between gentamicin dosing, duration of treatment, and ototoxicity in hospitalized infants.Study designThis retrospective cohort study conducted at 330 neonatal intensive care units (2002-2014) included inborn infants exposed to gentamicin with available hearing screen results, and excluded infants with incomplete dosing data and major congenital anomalies. Our primary outcome was the final hearing screen result performed during hospitalization: abnormal (failed or referred for further testing in one or both ears) or normal (bilateral passed). The 4 measures of gentamicin exposure were highest daily dose, average daily dose, cumulative dose, and cumulative duration of exposure. We fitted separate multivariable logistic regression models adjusted for demographics, comorbidities, and other clinical events.ResultsA total of 84 808 infants met inclusion/exclusion criteria; median (25th, 75th percentile) gestational age and birth weight were 35 weeks (33, 38) and 2480 g (1890, 3184), respectively. Failed hearing screens occurred in 3238 (3.8%) infants; failed screens were more likely in infants of lower gestational age and birth weight, who had longer hospital lengths of stay, higher rates of morbidities, and were small for gestational age. Median highest daily dose, average daily dose, and cumulative dose were 4.0 mg/kg/day (3.0, 4.0), 3.8 mg/kg/day (3.0, 4.0), and 12.1 mg/kg (9.1, 20.5), respectively. Median cumulative duration of exposure was 3 days (3, 6). In adjusted analysis, gentamicin dose and duration of therapy were not associated with hearing screen failure.ConclusionsGentamicin dosing and duration of treatment were not associated with increased odds of failed hearing screen at the time of discharge from initial neonatal intensive care unit stay.