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Comparative Study
. 2015 Jan;35(1):67-71.
doi: 10.1038/jp.2014.135. Epub 2014 Jul 24.

Critical congenital heart disease screening by pulse oximetry in a neonatal intensive care unit

V Manja  1 , B Mathew  2 , V Carrion  2 , S Lakshminrusimha  2
Affiliations
Comparative Study

Critical congenital heart disease screening by pulse oximetry in a neonatal intensive care unit

V Manja et al. J Perinatol. 2015 Jan.

Abstract

Objective: Critical congenital heart disease (CCHD) screening is effective in asymptomatic late preterm and term newborn infants with a low false-positive rate (0.035%). (1) To compare 2817 neonatal intensive care unit (NICU) discharges before and after implementation of CCHD screening; and (2) to evaluate CCHD screening at <35 weeks gestation.

Study design: Collection of results of CCHD screening including pre- and postductal pulse oximetry oxygen saturation (SpO2) values.

Result: During the pre-CCHD screen period, 1247 infants were discharged from the NICU and one case of CCHD was missed. After 1 March 2012, 1508 CCHD screens were performed among 1570 discharges and no CCHDs were missed. The pre- and postductal SpO2 values were 98.8 ± 1.4% and 99 ± 1.3%, respectively, in preterm and 98.9 ± 1.3% and 98.9 ± 1.4%, respectively, in term infants. Ten infants had false-positive screens (10/1508 = 0.66%).

Conclusion: Performing universal screening in the NICU is feasible but is associated with a higher false-positive rate compared with asymptomatic newborn infants.

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Conflict of interest statement

Conflict of interest: The authors have no conflicts of interest relevant to this article to disclose

Figures

Figure 1
Figure 1
Flowchart showing distribution of patients based on universal screen conducted in the NICU from March 2012 to March 2014. Abbreviations: CCHD – critical congenital heart disease, NICU – neonatal intensive care unit; PDA – patent ductus arteriosus; PFO – patent foramen ovale; PPHN – persistent pulmonary hypertension of the newborn; TAPVR – total anomalous pulmonary venous return.
Figure 2
Figure 2
The frequency distribution (%) of the difference between preductal and postductal saturations in preterm (less than or equal to 34 weeks 6/7 days PMA) and term neonates (greater than or equal to 35 weeks 0/7 days PMA) and all infants.
See this image and copyright information in PMC

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