974: FEASIBILITY OF OTOACOUSTIC EMISSIONS TESTING TO IDENTIFY HEARING IMPAIRMENT IN THE ICU

Abstract

Introduction: Hearing impairment is associated with a lack of functional recovery among older adults who have survived intensive care unit (ICU) admission and is a risk factor for delirium. Identifying hearing impairment in the ICU is challenging because many patients cannot participate in hearing assessments. Otoacoustic emissions testing (OAE) is a non-invasive, non-participatory tool that is used to screen newborns for hearing impairment by detecting intracochlear motion in response to auditory stimulation. Our objective was to assess the feasibility of OAE testing to screen for hearing impairment among adults in the ICU. Methods: A feasibility study was performed in the adult Medical Intensive Care Unit at Yale-New Haven Hospital. Data were gathered on demographics, delirium, ventilation status, sedation, illness severity, OAE measurements, and ambient noise. Percentage of test completion, the average time of test completion, and barriers or facilitators of testing were measured as outcomes. A patient passed their OAE testing if at least 2 of 6 frequencies were detected in at least one ear. A pass suggested that moderate or severe hearing impairment (i.e., that would require an amplifier or a hearing aid) was not present. Results: Of 31 patients approached (mean age 64.58+/-14.06 years), 23 (74.2%) underwent testing. Among all patients, 15 (48.4%) were mechanically ventilated, 8 (25.8%) were receiving sedative infusions, and 19 (61.3%) screened positive for delirium with the CAM-ICU. Eight (25.8%) patients were unable to be tested, most commonly due to elevated ambient noise (41.6%). Among the 18 patients with complete data, 6 patients screened positive for hearing impairment. The average time for OAE test completion per ear was 152.59+/-97.57 seconds. The average ambient noise level was 50.68+/-3.96 dB for all patients, and 52.41+/-2.08 dB among those who could not be tested in both ears. Conclusions: OAE testing is a feasible method for hearing impairment screening in the ICU. Identification of hearing impairment may facilitate improved communication through interventions such as amplifiers, audiology referrals, and accommodations. Future studies should evaluate whether identification and treatment of hearing impairment in the ICU may reduce delirium and improve post-ICU recovery.