Journal of Pediatric Perspectives

Pulse Oximetry Screening for Detecting Congenital Heart Disease in Neonates – Experience from Tertiary Referral Children’s Hospital in South India

Ashwini R C; Sushil Kumar K; Shashidhar Sankratti; Mugangowda Patil

Volume 12, Issue 3 , March 2024, , Pages 18620-18627

https://doi.org/10.22038/ijp.2024.77015.5408

Abstract

Background: Congenital heart disease is the most common type of birth defect in infancy with incidence of 8 to 12 per 1000 live births in India. Pulse oximetry has emerged as a good ... Read More Background: Congenital heart disease is the most common type of birth defect in infancy with incidence of 8 to 12 per 1000 live births in India. Pulse oximetry has emerged as a good screening tool in the recent past in many countries being noninvasive and cost effective. This study aimed at estimating the accuracy of pulse oximetry as a standard screening method to detect congenital heart diseases (CHD) in neonates.Methods: This prospective observational study was conducted in a tertiary referral medical college hospital from December 2018 to June 2020. Pulse oximetry readings were taken of 1603 asymptomatic neonates breathing in room air from right hand and either foot after 24 hours of birth. Pulse oximetry was considered positive if oxygen saturation in room air measured <95% or difference between right hand and foot was more than 3% persistently for 3 readings as per the standard American Academy of Pediatrics algorithm. Neonates with positive pulse oximetry or those with persistent abnormal clinical examination underwent echocardiography.Results: Of the term neonates (n=1603) screened, incidence of CHD was 0.7 per 1000 live births and critical CHD was 0.3 per 1000 live births. The sensitivity, specificity, positive predictive value, and negative predictive value of pulse oximetry to detect any CHD were 70.6%, 98.8%, 38.7%, and 99.7%, major CHD was found to be 60%, 98.4%, 19.4%, and 99.7%, and critical CHD to be 85.7%, 98.4%, 19.4%, and 99.9%, respectively. Pulse oximetry had significant positive correlation with abnormal clinical examination (R=0.29, p<0.001) and ECHO findings in detecting CHD (R=0.49, p<0.001). Regression model to evaluate whether abnormal clinical examination and positive pulse oximetry are significant predictors of CHD detected by ECHO was statistically significant (R2 =0.34, p value <0.001) and both were significant independent predictors (p<0.001).Conclusion: Pulse oximetry screening is a useful tool for detecting congenital heart diseases in newborns.

Oxygen Saturation Screening Test: A Useful Method for Predicting Complex Congenital Heart Disease in Newborns

Behzad Alizadeh; Ahmad Shah Farhat; Nazanin Hazrati

Volume 10, Issue 2 , February 2022, , Pages 15460-15465

https://doi.org/10.22038/ijp.2022.59225.4610

Abstract

Background: Critical congenital heart diseases (CCHDs) are the most common group of congenital malformations in newborns, the mortality and morbidity of which may be prevented by early ... Read More Background: Critical congenital heart diseases (CCHDs) are the most common group of congenital malformations in newborns, the mortality and morbidity of which may be prevented by early diagnosis. As a simple and noninvasive technique in detecting hypoxemia, pulse oximetry can help us in the early diagnosis of complex congenital heart diseases. This study aims to provide information for future clinical and health policy decisions for making a Uniform Screening Panel in the early detection of CCHDs in newborns.Methods: In this study, we determine the prevalence of congenital heart disease in newborns with Oxygen Saturation in the Maternity ward of Imam-Reza Hospital in Mashhad, Iran.Material and Methods: This is a prospective clinical study which was conducted in the Maternity ward of Imam-Reza hospital between March 2018 and March 2019. We recorded Spo2 of the newborns between 4 to 24 hours after delivery by a trained general practitioner using RS232C/NOVAMETRIX Pulse Oximetry device. The newborn also underwent a comprehensive clinical examination by a neonatologist, and further cardiological evaluation was performed afterward. A pediatric cardiologist performed Echocardiography for the final diagnosis if there was no evidence of other non-cardiac pathologies. Statistical analysis of data was done by SPSS version 24.Results: Out of a total of 418 newborns screened by a pulse oximetry device, four newborns were screen-positive, and had pulse oximetry tests with Spo2 results. Two of these patients were reported to have complex congenital heart diseases, subsequently. The remaining two newborns with positive screening tests had no congenital heart disease in echocardiography evaluation.Conclusion: This study revealed that a pulse oximetry screening test could be beneficial for detecting many of the newborns with CCHDs before hospital discharge. However, further research studies with larger sample sizes are necessary for a definitive result.

Validity of Spo2/Fio2 Ratio in Detection of Acute Lung Injury and Acute Respiratory Distress Syndrome

Nemat Bilan; Azar Dastranji; Afshin Behbahani ghalehgolab

Volume 3, Issue 1.2 , February 2015, , Pages 429-434

https://doi.org/10.22038/ijp.2015.3840

Abstract

Introduction: One ofdiagnostic criteria for Acute Lung Injury and Acute Respiratory Distress Syndrome is pao2/fio2 (PF) ratio 300 for ALI or 200 for ARDS. This criteria ... Read More

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Keywords = Pulse oximetry

Pulse Oximetry Screening for Detecting Congenital Heart Disease in Neonates – Experience from Tertiary Referral Children’s Hospital in South India

Abstract

Oxygen Saturation Screening Test: A Useful Method for Predicting Complex Congenital Heart Disease in Newborns

Abstract

Validity of Spo2/Fio2 Ratio in Detection of Acute Lung Injury and Acute Respiratory Distress Syndrome

Abstract