Congenital CMV and Timely Newborn Hearing Screens in the NICU

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Congenital CMV and Timely Newborn Hearing Screens in the NICU CONGENITAL CYTOMEGALOVIRUS (cCMV) Melanie Boogaard, BSN, Neonatal DNP Student Thanks to Dr. Roger Faix, MD & Dr. Pam Phares, PhD, APRN Cytomegalovirus is a common virus that can be transmitted to a developing fetus during pregnancy, affecting 40,000-80,000 infants in the US each year. The majority of infants are asymptomatic and long-term sequelae include: cognitive deficit, vision impairment, and hearing loss. AIMS The purpose of this project is to evaluate the feasibility of conducting NHS within the first three weeks of life to improve detection of CMV in NICU infants. Eligible for NHS?  >32 weeks gestation  50 mL/min or less oxygen flow  Off of ototoxic medications  Clinically stable CLINICAL SIGNIFICANCE Improved methods for detecting cCMV must be explored and tested. Retrospective Prospective 14 7 3 0 Inpatients in the NICU at 21 DOLIneligible for NHS NICU infants currently have their NHS completed prior to discharge, but not necessarily before three weeks of age when cCMV is most accurately detected. 42 40 Inpatients in the NICU at 21 DOLEligible for NHS A failed newborn hearing screen (NHS) is a symptom of cCMV, and is a reason to perform testing for cCMV. 45 40 35 30 25 20 15 10 5 0 RESULTS: • A retrospective chart review and prospective trial were completed to determine the clinical impact of early NHS • The majority of infants were discharged from the NICU before 21 days of life (DOL). • Oxygen requirements in neonates precluded early NHS in 3 infants • All seven infants identified prospectively that were screened using the new criteria all passed their NHS successfully. • NHS is safe and appropriate as early as 32 weeks gestation Infants admitted to the NICU at >30 weeks gestation # of Infants Discharged Before 21 DOL The newborn intensive care unit (NICU) PROCEDURES population presents unique challenges in screening for cCMV. METHODS & FINDINGS CONCLUSIONS The interprofessional team recommends evaluating infants born at >30 weeks gestation at DOL 14 admitted to the NICU for early NHS eligibility. NHS and subsequent cCMV testing needs to be completed before DOL 21 when feasible. This will increase detection of cCMV in NICU infants.