Pulse oximetry could significantly enhance the early detection of critical congenital heart disease in neonatal intensive care units

Abstract

Aim: Limited data have been available regarding critical congenital heart disease (CHD) screening in neonatal intensive care unit (NICUs). This study evaluated the feasibility of screening for CHD by adding pulse oximetry (POX) to clinical evaluation in a NICU in Shanghai, China.

Methods: We screened 4128 eligible consecutive NICU admissions using POX plus clinical evaluation. Infants with positive screening results were then evaluated with echocardiography. Those with negative screening results were put under observation, and they also underwent echocardiography if their oxygen saturation fell below 95% on room air during hospitalisation.

Results: This enhanced procedure detected 19 critical CHD cases, and seven of these diagnoses would have been delayed if POX had not been incorporated into the screening strategy. This means that the addition of POX increased the detection rate of critical CHD from 63.2 to 100%. The false-positive rate of critical CHD screening using POX plus clinical evaluation was higher in NICU patients with high morbidity rates.

Conclusion: When pulse oximetry screening was added to clinical evaluation, it increased the number of critical CHD cases that were detected in our NICU. This method could provide a useful screening protocol for critical CHD cases.

Keywords: Clinical evaluation; Congenital heart disease; Neonatal intensive care unit; Neonatal screening; Pulse oximetry.