RT Journal Article
SR Electronic
T1 Temporal trends in routine predischarge pulse oximetry screening: 6 years’ experience in a UK regional neonatal unit
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 256
OP 261
DO 10.1136/archdischild-2021-322303
VO 107
IS 3
A1 Amy Henderson
A1 Diana Aguirre
A1 Anju Singh
A1 Andrew K Ewer
YR 2022
UL http://fn.bmj.com/content/107/3/256.abstract
AB Objectives To evaluate the continued impact of pulse oximetry screening (POS) in a regional neonatal unit (NNU) and identify trends in screening outcomes in comparison with our previous experience.Design Retrospective review of admissions between April 2013 and March 2019 (the current study) and comparison with previously published data (the 2014 study).Patients All infants >34 weeks completed gestation admitted to NNU as a result of positive POS.Outcome measures Indication for admission, diagnosis, investigations and management.Results There were 49 375 livebirths and 253 NNU admissions as a result of positive POS (0.5% of livebirths; compared with 0.8% in 2014). 247/253 (97.6%) of those admitted had a significant diagnosis requiring medical intervention (compared with 79% in 2014) and the proportion of healthy babies (with transitional circulation) admitted decreased from 21% to 2.4%.22 (9%) babies admitted as a result of a positive POS were found to have a previously undiagnosed congenital heart defect (CHD) of which eight were critical CHDs (CCHDs). This accounted for 73% of all undiagnosed CCHD undergoing POS. The antenatal detection rate of CCHD was 75% compared with 46% in 2014. No baby died or collapsed on the postnatal ward during the study period. The proportion of babies with CCHD identified before discharge improved from 94% to 99%.Conclusions Routine POS, in addition to antenatal screening and postnatal examination, continues to contribute to the improvement of our overall CCHD detection rates. We have demonstrated an overall reduction in the admission of healthy babies and therefore workload following a positive test.Data are available on reasonable request. Anonymised raw patient data are available on reasonable request.