| Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the AHA and AAP. | |
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MedLine Citation:
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PMID: 19581259 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this statement is to address the state of evidence on the routine use of pulse oximetry in newborns to detect critical congenital heart disease (CCHD). METHODS AND RESULTS: A writing group appointed by the American Heart Association and the American Academy of Pediatrics reviewed the available literature addressing current detection methods for CCHD, burden of missed and/or delayed diagnosis of CCHD, rationale of oximetry screening, and clinical studies of oximetry in otherwise asymptomatic newborns. MEDLINE database searches from 1966 to 2008 were done for English-language papers using the following search terms: congenital heart disease, pulse oximetry, physical examination, murmur, echocardiography, fetal echocardiography, and newborn screening. The reference lists of identified papers were also searched. Published abstracts from major pediatric scientific meetings in 2006 to 2008 were also reviewed. The American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. In an analysis of pooled studies of oximetry assessment performed after 24 hours of life, the estimated sensitivity for detecting CCHD was 69.6%, and the positive predictive value was 47.0%; however, sensitivity varied dramatically among studies from 0% to 100%. False-positive screens that required further evaluation occurred in only 0.035% of infants screened after 24 hours. CONCLUSIONS: Currently, CCHD is not detected in some newborns until after their hospital discharge, which results in significant morbidity and occasional mortality. Furthermore, routine pulse oximetry performed on asymptomatic newborns after 24 hours of life, but before hospital discharge, may detect CCHD. Routine pulse oximetry performed after 24 hours in hospitals that have on-site pediatric cardiovascular services incurs very low cost and risk of harm. Future studies in larger populations and across a broad range of newborn delivery systems are needed to determine whether this practice should become standard of care in the routine assessment of the neonate. |
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Authors:
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William T Mahle; Jane W Newburger; G Paul Matherne; Frank C Smith; Tracey R Hoke; Robert Koppel; Samuel S Gidding; Robert H Beekman; Scott D Grosse; ; ; |
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Publication Detail:
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Type: Journal Article Date: 2009-07-06 |
Journal Detail:
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Title: Pediatrics Volume: 124 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-08-04 Completed Date: 2009-08-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 823-36 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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American Heart Association* Cross-Sectional Studies Evidence-Based Medicine Health Policy* Heart Defects, Congenital / diagnosis*, mortality Humans Infant, Newborn Neonatal Screening Oximetry* Pediatrics* Sensitivity and Specificity Societies, Medical* Survival Rate Ultrasonography, Prenatal United States |
| Investigator | |
Investigator/Affiliation:
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W T Mahle / ; J W Newburger / ; G P Matherne / ; F C Smith / ; T R Hoke / ; R Koppel / ; S S Gidding / ; R H Beekman / ; S D Grosse / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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