RT Journal Article
SR Electronic
T1 Should pulse oximetry be used to screen for congenital heart disease?
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F219
OP F224
DO 10.1136/adc.2005.090282
VO 92
IS 3
A1 Pekka Valmari
YR 2007
UL http://fn.bmj.com/content/92/3/F219.abstract
AB Ten studies (44 969 newborns, 71 severe defects) evaluating the usefulness of neonatal pulse oximetry (PO) screening in timely detection of congenital heart disease (CHD) were reviewed. PO showed a high specificity (99.9–99.99%), and the overall rate of detection of 15 individual defects with PO was 72% (range 46–100%), exceeding that of the clinical examination 58% (9–86%). Similar results were obtained for cyanotic CHD (89% v 69%, respectively). Without PO, discharge of apparently healthy infants with unknown CHD was 5.5 times and 4.1 times more likely in cyanotic CHD and all serious CHD, respectively. The paper describes the technical and practical details of first day and later screening. Diagnosis is reached earliest with first day screening, but it requires more resources. PO screening is not sensitive enough to serve as an independent screen, but along with the clinical examination it helps minimise the morbidity and mortality associated with discharge without diagnosis. Further research is needed for precise delineation of populations that would benefit from PO screening.