1492 BRAINSTEM AUDITORY EVOKED RESPONSE (BAER) IN PRETERM INFANTS WITH INTRAVENTRICULAR HEMORRHAGE (IVH)

Abstract

The usefulness of BAER as an indicator of brain dysfunction in IVH was evaluated in 52 infants <35 wks gestation. A CA1000 Nicolet machine with click stimulus at 75 dbs (rate 23/sec, duration 100 μsec, 2000 repetitions) was used to test each ear on day 1, 2, 3, 4 and weekly until discharge. The latency of wave V which was most consistently present is reported. IVH was documented by daily cranial sonograms. 21 infants had IVH and 31 did not (Grade I-7, Gr II-8, Gr III-4, Gr IV-2). 7 infants with Grade II IVH progressed to ventriculomegaly at discharge. The mean ±2SD wave V latency in non-IVH infants decreases from 7.93±1.60 msec at (≤30 wk), 8.2±1.62 (31-32 wk), 8.27±1.62 (33-35 wk), 7.54±.90 (≥36 wk), the difference being significant beyond 36 wks (p<.02). For each of the above gestational ages a significantly smaller number of IVH infants showed an auditory response (p<.001); however, there was no significant difference in latency when a response was obtained: 8.39±1.66 (32 wk), 7.66±1.44 (33-35 wk), 7.53±.98 (≥36 wk). For both groups BAER was most consistently elicited by 34 wks whether or not the infant was on the ventilator. These findings indicate that IVH is associated with global brain dysfunction that suppresses the evoked response; however, it may not indicate specific hearing impairment. BAER may be valuable to document brain dysfunction and recovery in the acute phase of IVH.

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