Document Detail

Evaluation of pulse oximetry screening in Middle Tennessee: cases for consideration before universal screening.
MedLine Citation:
PMID:  20508595     Owner:  NLM     Status:  In-Data-Review    
Objective:Pulse oximetry screening of asymptomatic newborns is suggested as a life-saving procedure for the timely detection of critical congenital heart disease (CHD) in asymptomatic newborns. We evaluated this screening and report cases that demonstrate problems with screening in a non-research setting.Study Design:An elective state-directed public health screening program was evaluated in Middle Tennessee; 14 564 infants were screened after 24 h of age and before discharge. The screening was performed in a non-research setting by nurses at the local hospitals. A parallel investigation of the methods and timing of diagnosis in Middle Tennessee revealed a surprisingly high incidence of antenatal diagnosis (66%).Result:Using a saturation value of 94% as the defined normal, the positive predictive value was less than 1%, with 112 infants having a false positive case and 1 having a true positive case identified (incidence 1/34 775). The one true positive case was not referred for evaluation. One false-positive case resulted in a costly referral and hospitalization. Antenatal diagnosis when combined with physical examination detected 43 of 44 infants with critical CHD during the year-long evaluation.Conclusion:Before universal screening can be implemented, a system of care must be defined to address the educational and referral issues raised by this report.
W Walsh
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Publication Detail:
Type:  Journal Article     Date:  2010-05-27
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  31     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  125-9     Citation Subset:  IM    
Division of Neonatology, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN, USA.
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