Pulse oximetry as a screening method for early detection of critical congenital heart disease in newborns in the region of Northern Slovakia
Authors:
K. Maťašová 1; Z. Bukovinská 1; M. Jánoš 2; M. Hrivková 2; J. Bartošová 3; E. Koubeková 4; A. Pillarová 5; J. Dudášová 6; M. Krajčiová 7; E. Nemcová 8; J. Dvorská 9; A. Šparcová 10; A. Jurko jr. 11; M. Zibolen 1
Authors‘ workplace:
Neonatologická klinika JLF UK a UNM, Martin
prednosta prof. MUDr. M. Zibolen, CSc.
1; Novorodenecké oddelenie FNsP, Žilina
primár MUDr. M. Jánoš
2; Novorodenecké oddelenie KNsP, Čadca
primár MUDr. J. Bartošová
3; Novorodenecké oddelenie HNsP, Trstená
primár MUDr. E. Koubeková
4; Detské oddelenie, novorodenecký úsek NsP, Bojnice
primár MUDr. A. Pillarová
5; Neonatologické oddelenie DONsP, Dolný Kubín
primár MUDr. J. Dudášová
6; Novorodenecké oddelenie LNsP MUDr. I. Stodolu, Liptovský Mikuláš
primár MUDr. M. Krajčiová
7; Neonatologické oddelenie ÚVN SNP FN, Ružomberok
primár MUDr. E. Nemcová
8; Detské oddelenie, 2. súkromná nemocnica, s. r. o., Nemocnica Handlová
primár MUDr. P. Mífek
9; Klinika detí a dorastu JLF UK a UNM, Martin
prednosta prof. MUDr. P. Bánovčin, CSc.
10; Pediatrická kardiológia, Martin
vedúci doc. MUDr. A. Jurko Jr., PhD.
11
Published in:
Čes-slov Pediat 2011; 66 (3): 146-152.
Category:
Original Papers
Overview
Aim:
To evaluate the efficacy of the routine use of pulse oximetry to detect critical congenital heart disease (CCHD) in the region of Northern Slovakia.
Methods:
Postductal saturation was recorded prospectively in healthy term infants born from 15.11.2009 to 31.10.2010. The first screen was performed at the age of 6–12 hours. If pulse-oximetry measured arterial oxygen saturation was lower than 95%, the screening was positive and it was repeated in 6 hours intervals until the age of 30 hours.
Results:
7280 infants were included in the study. The CCHD was detected due to the screening in 7 out of the infants. The sensitivity was 87.5%, specificity 98.9% and negative predictive value 99%. The false negative result was recorded in 1 baby with the hypoplastic left heart syndrome that was diagnosed clinically at the age of 2 days. In a randomly chosen subgroup of infants without CCHD the screening was positive in 77 out of the 3210 newborns (2.39%). Up to 24 hours the saturation was normal in 63 out of them, they were healthy and the positive screening was due to the transitional circulation (mean saturation 93.03±1.16%, median 93%). In remaining 14 out of the 77 infants other disease was diagnosed and the saturation was less than 95% in 50% out of them at the age of 24 hours (saturation 90.64±4.38%, median 92%). The saturation in infants with CCHD was 86.0±5.6%, median 87%.
Conclusion:
Pulse oximetry is an effective screening method for early detection of CCHD at asymptomatic stage. If the postductal saturation is less than 90% at the age of 24 hours, echocardiographic examination is indicated. Babies with saturation between 90 and 94% should have a second screen 6–12 hours later. If it is positive, the cardiologic and other necessary examinations are performed. Comparison of saturation values from the right hand and either foot increases the effectiveness of the screening.
Key words:
pulse oximetry, critical congenital heart disease, postductal saturation, screening method
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2011 Issue 3
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