Document Detail

Implication of pulse oxymetry screening for detection of congenital heart defects.
MedLine Citation:
PMID:  20458668     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In newborns congenital heart defects can take an asymptomatic course, causing a diagnostic gap in the routine examination. Therefore pulsoxymetric screening is under discussion, as it could close this diagnostic gap.
PATIENTS AND METHODS: Non-invasive postductal peripheral oxygen saturation assessment was carried out in 3 364 term neonates, 6-36 h of age, in 2008. In asymptomatic neonates with values > or = 95%, no further steps were applied. In those with values between 90% and 94% and no clinical abnormalities, a check-up was carried out 4-6 h later. Echocardiography was performed when the initial value was below 90% or persisted < 95 %.
RESULTS: A total of 18 (0.5%) abnormal pulse oximetry values requiring echocardiographic investigation were found in the 3 364 neonates examined. 9 congenital heart defects that had not been recognized prenatally were diagnosed. 4 of these children were also found to have anomalies at the clinical examination. Persistent fetal circulation was noted in 2 of the neonates.In addition neonatal infections has been detected in 7 newborns. 1 neonate with stenosis of the aortic isthmus and 1 with pulmonary stenosis were missed in the screening program, with pulse oximetry saturation levels >95%. These data represent a sensitivity of 82% and a specificity of 99.9%, with a positive predictive value of 50% and a negative predictive value of 99.9%.
CONCLUSIONS: Together with the clinical examination, pulse oximetry in neonates is a screening method that has high levels of sensitivity and specificity for early diagnosis of congenital heart defects. The risk-benefit profile may favour pulse oximetry to be standardized and universally used.
J Tautz; C Merkel; F Loersch; O Egen; F Hägele; H-M Thon; T Schaible
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Publication Detail:
Type:  Journal Article     Date:  2010-05-10
Journal Detail:
Title:  Klinische Pädiatrie     Volume:  222     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2011-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  291-5     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart, New York.
Department of Pediatrics, Universitätsmedizin Mannheim, Mannheim, Germany.
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MeSH Terms
Cohort Studies
Heart Defects, Congenital / blood,  diagnosis*
Infant, Newborn
Neonatal Screening*
Oximetry* / statistics & numerical data
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Ultrasonography, Prenatal

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