scholarly journals Association between oxygen saturation and critical congenital heart disease in newborns

2018 ◽  
Vol 58 (2) ◽  
pp. 90-4
Author(s):  
Lidia Halim ◽  
Muhammad Ali ◽  
Tiangsa Sembiring
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Screening Program ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Critical Congenital Heart Disease ◽  
Cross Sectional

Background Critical congenital heart disease (CCHD) is relatively common, with a prevalence of 6-8 in every 1,000 live births. This congenital anomaly is a newborn condition that would be ideally suited for a screening program, if simple and reliable methods were available. Pulse oximetry (PO) has been proposed as a screening method to detect CCHD. Objective To assess for a possible association between decreased oxygen saturation and CCHD in newborns. Methods We conducted a cross-sectional study from March 2014 to February 2015 in several hospitals in North Sumatra. Healthy, full term and post-term newborns aged 2 to 72 hours underwent pulse oximetry measurements on the right hand and one of the lower extremities. If oxygen saturation (SpO2) was ≤ 95%, the measurement was repeated 2 more times. Subjects also underwent echocardiography. Results A total of 386 newborns underwent SpO2 measurements: 377 newborns had SpO2 > 95% and 9 newborns had SpO2 ≤ 95%. Of the infants with SpO2 > 95%, 297 were excluded because their parents refused echocardiography examination. Thus, 80 newborns with SpO2 > 95% and 9 newborns with SpO2 ≤ 95% underwent echocardiography. Echocardiography revealed that 5 of 9 newborns with SpO2 ≤ 95% suffered from Tetralogy of Fallot (ToF) (3 subjects) and transposition of the great arteries (TGA) (2 subjects). One infant with SpO2 > 95% had ventricular septal defect (VSD), as detected by echocardiography. Oxygen saturation ≤ 95% had significant association with CCHD (P<0.001). Conclusion Decreased oxygen saturation has a significant association with critical congenital heart disease in newborns.

Should we start a nationwide screening program for critical congenital heart disease in Turkey? A pilot study on four centres with different altitudes

2019 ◽  
Vol 29 (4) ◽  
pp. 475-480
Author(s):  
Dilek Dilli ◽  
Vehbi Doğan ◽  
Banu M. Özyurt ◽  
Abdullah Özyurt ◽  
Nilay Hakan ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Screening Program ◽  
Critical Congenital Heart Disease ◽  
Multi Centre Study ◽  
Geographical Regions ◽  
The Mean ◽  
Different Altitudes

AbstractBackground:To investigate the feasibility of critical congenital heart disease (CCHD) screening test by pulse oximetry in four geographical regions of Turkey with different altitudes, before implementation of a nationwide screening program.Methods:It was a prospective multi-centre study performed in four centres, between December, 2015 and May, 2017. Pre- and post-ductal oxygen saturations and perfusion indices (PI) were measured using Masimo Radical-7 at early postnatal days. The results were evaluated according to the algorithm recommended by the American Academy of Pediatrics. Additionally, a PI value <0.7 was accepted to be significant.Results:In 4888 newborns, the mean screening time was 31.5 ± 12.1 hours. At first attempt, the mean values of pre- and post-ductal measurements were: saturation 97.3 ± 1.8%, PI 2.8 ± 2.0, versus saturation 97.7 ± 1.8%, PI 2.3±1.3, respectively. Pre-ductal saturations and PI and post-ductal saturations were the lowest in Centre 4 with the highest altitude. Overall test positivity rate was 0.85% (n = 42). CCHD was detected in six babies (0.12%). Of them, right hand (91 ± 6.3) and foot saturations (92.1 ± 4.3%) were lower compared to ones with non-CCHD and normal variants (p <0.05, for all comparisons). Sensitivity, specificity, positive and negative predictive values, and likelihood ratio of the test were: 83.3%, 99.9%, 11.9%, 99.9%, and 99.2%, respectively.Conclusion:This study concluded that pulse oximetry screening is an effective screening tool for congenital heart disease in newborns at different altitudes. We support the implementation of a national screening program with consideration of altitude differences for our country.

scholarly journals Early detection of and intervention for two newborns with critical congenital heart disease using a specialized device as part of a screening system

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092604
Author(s):  
René Gómez-Gutiérrez ◽  
Héctor Cruz-Camino ◽  
Consuelo Cantú-Reyna ◽  
Adrián Martínez-Cervantes ◽  
Diana Laura Vazquez-Cantu ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Screening Program ◽  
Disease Screening ◽  
Therapeutic Interventions ◽  
Critical Congenital Heart Disease ◽  
Clinical Method

Screening for critical congenital heart disease is a clinical method used for their early detection using pulse oximetry technology. This, followed by a diagnostic confirmatory protocol, allows timely therapeutic interventions that improve the newborn’s outcome. According to Mexican birth statistics, approximately 18,000–21,000 neonates are born with a form of congenital heart disease each year, of which 25% are estimated to be critical congenital heart disease. We report two cases with an early critical congenital heart disease detection and intervention through an innovative critical congenital heart disease screening program implemented in two Mexican hospitals. They integrated a new automated pulse oximetry data analysis method and a comprehensive follow-up system (Cárdi-k®). Both cases were confirmed by echocardiogram, which served for an intervention in the first week of life, and the patients were discharged in good clinical condition. In addition, to the routine physical assessments, the critical congenital heart disease screening program (which includes echocardiogram for presumptive positive cases) should be implemented in a timely manner.

scholarly journals Oxygen saturation among newborns in the first 10 hours of life to detect Critical Congenital Heart Disease - Ductus Dependent

2020 ◽  
Vol 4 (2) ◽  
pp. 237
Author(s):  
Fatchul Wahab ◽  
Mahrus Abdul Rahman ◽  
Teddy Ontoseno ◽  
Risa Etika ◽  
Alit Utamayasa ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Gold Standard ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease ◽  
Exact Test ◽  
Consecutive Sampling ◽  
The Right

ABSTRACT Delay diagnosis of Critical Congenital Heart Disease (CHD) can be associated with sudden clinical deterioration and dangerous cardiovascular conditions. The oxygen saturation screening among newborns in the first 10 hours of life is essential for early detection of critical CHD. This study aims to prove that measuring oxygen saturation among newborns in the first 10 hours of life can detect critical CHD. This study is a diagnostic experimental with consecutive sampling subjects in the infant care unit of Dr. Soetomo Hospital, including all newborns with birth weight ≥ 1500 grams and oxygen saturation at ≥ 1 hour of age below 90%. The measurement of oxygen saturation uses fingertip pulse oximetry in the right hand and foot at the age of 10 hours. A "positive oxygen saturation" is defined as oxygen saturation ≤ 85% or different oxygen saturation ≥ 3%, while a "negative oxygen saturation" is when the oxygen saturation is 85% to 90% or different oxygen saturation is 3%. Echocardiography is performed for the gold standard. From November 2019 to January 2020, 11 newborns underwent an oxygen saturation examination. Five subjects (45.46%) in the category of positive oxygen saturation, echocardiographic showed all Critical CHD (100%). Six subjects (54.54%) with negative oxygen saturation category, echocardiographic results showed two critical CHD (33.34%) and four non-critical CHD (66.66%). Fisher's exact test p < 0.005 (α). The diagnostic oxygen saturation test among newborns at 10 hours of life shows ≤85%, all subject’s echocardiography (100%) shows detection of critical CHD, while saturation 85% to 90% has of 33.3% for detection of critical CHD. The sensitivity and specificity of oxygen saturation for early diagnosis of critical CHD are 100% and 67%, respectively. Keywords: critical congenital heart disease, oxygen saturation, fingertip pulse oximetry, diagnostic tests*Corresponding Author: [email protected]

scholarly journals Study the universal critical congenital heart disease screening in a peripheral area of Uttarakhand, India

2020 ◽  
Vol 7 (9) ◽  
pp. 1849
Author(s):  
Ravi Sahota ◽  
Navpreet Kaur ◽  
Gurpal Singh ◽  
Veena Joshi ◽  
Bharti Gahtori ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Screening Program ◽  
Heart Diseases ◽  
Research Work ◽  
Congenital Heart Diseases ◽  
Critical Congenital Heart Disease ◽  
Cross Sectional ◽  
Birth Prevalence

Background: Congenital heart disease (CHD) is the most frequently occurring congenital disorder, responsible for 28% of all congenital birth defects. The birth prevalence of CHD is reported to be 8-12/1000 live births. Considering a rate of 9/1000, about 1.35 million babies are born with CHD each year globally. Objective of research work to study the prevalence of CHD among newborn and its types.Methods: This cross-sectional study was carried among 34 cases of CHD/5126 newborn screened at 4 birthing places in Kashipur a small town in Uttrakhand at pediatrics department of Sahota Super-specialty hospital, Kashipur, Uttarakhand. Screening program between 22 August 2014, and March 30, 2019. All newborns, including preterm babies, delivered in these facilities were eligible for inclusion in this study.Results: Present study found the prevalence of CHD was 0.7 per 1000 children (34/5126). Around 26.5% participants have cyanotic CHD and 73.5% have acynotic CHD. Almost 44%, 28%, 20%, 4% and 4% participants of acynotic congenital heart diseases have VSD, ASD, PDA, AVSD and valvular PS respectively and 55.6%, 22.2%, 11.1% and 11.1% participants of cynotic congenital heart diseases have TOF, DORV/VSD, dTGA/VSD and tricuspid atresia respectively.Conclusions: Screening for congenital heart disease should be included as a part of newborn assessment as it is a common congenital problem. Early identification influences outcome. Barriers in implementation of the screening programmes in resource limited setting is a challenging feature. This study can provide observed data that can help in policy making in the health sector.

scholarly journals Comparative study of pulse oximetry, physical examination and echocardiography results in the diagnosis of congenital heart defects in neonates in the first 24 hours of life

2021 ◽  
Author(s):  
Fatemeh Amiri Simkouii ◽  
Maryam Jamshidi ◽  
Mostafa Behjati Ardakani ◽  
Farzaneh Toosi ◽  
Mohammad Reza Alipour ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Physical Examination ◽  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Statistical Tests ◽  
Arterial Oxygen Saturation ◽  
Screening Method ◽  
Arterial Oxygen

Introduction: Congenital heart disease is the most common congenital anomaly. About 50% of Neonates with congenital heart disease are asymptomatic in the first few days of life and are not diagnosed on initial examination. Pulse oximetry is a non-invasive method that can show the percentage of oxygen saturation in the blood and congenital heart disease. Methods: This was a descriptive cross-sectional study and the sampling method was census. Echocardiography was performed for all neonates with spo2 less than 95% and also neonates who were diagnosed with a problem by a cardiologist. After collecting the samples, the results obtained from pulse oximetry, physical examination and echocardiography were analyzed using SPSS software version 16 and statistical tests of Kolmogorov-Smirnov normality and Spearman correlation. Was investigated. Results: In pulse oximetry evaluation, 1.9% of neonates had spo2 (arterial oxygen saturation) less than 95%. 1.7% of neonates had heart problems in physical examination and 2.12% of neonates had heart problems in echocardiography. The highest correlation between pulse oximetry and echocardiography was 0.917. Conclusion: Considering the diagnostic importance of congenital heart diseases and their impact on a person's life, it is recommended that pulse oximetry be added to physical examinations at birth as a screening method for heart disease.

scholarly journals Pulse Oximetry Screening in newborn for early detection of Critical Congenital Heart Disease - A review

2017 ◽  
Vol 39 (3) ◽  
pp. 148-153
Author(s):  
Sukhendu Shekhar Sen ◽  
Taskina Mosleh ◽  
Ismat Jahan ◽  
Sanjoy Kumer Dey
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
False Positive Rate ◽  
Screening Method ◽  
Cost Effective ◽  
Critical Congenital Heart Disease ◽  
Diagnostic Modality

Approximately 9 of 1000 live births have congenital heart disease, of these ~25% have critical congenital heart disease (CCHD). Delayed or missed diagnosis of CCHD may result in acute cardiovascular collapse. Echocardiography is a necessary diagnostic tool but it’s cost is a severe limitation as a universal screening tool. Clinically undetectable hypoxemia is present to some degree in most CCHD and this technique can be used as a screening method for early detection. In 2012, a systematic review involving over 300,000 babies reported that pulse oximetry test is highly specific (99.9%) and moderately sensitive (76.5%) with a low false positive rate (0.05%). The test is simple, feasible, cost effective, highly specific and sufficiently sensitive to qualify for screening test. Parents and caregivers should be informed that pulse oximetry cannot detect all cases of CCHD. A positive test result needs to be confirmed by echocardiography, which is considered as the definitive diagnostic modality. Whenever possible, the echocardiogram should be interpreted by pediatric cardiologistsBangladesh J Child Health 2015; VOL 39 (3) :148-153

scholarly journals Pulse Oximetry Screening Has Not Changed Timing of Diagnosis or Mortality of Critical Congenital Heart Disease

2020 ◽  
Vol 41 (5) ◽  
pp. 899-904 ◽  
Author(s):  
Matthew J. Campbell ◽  
William O. Quarshie ◽  
Jennifer Faerber ◽  
David J. Goldberg ◽  
Christopher E. Mascio ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease ◽  
Pulse Oximetry Screening

Oxygen Saturation and Perfusion Index-Based Enhanced Critical Congenital Heart Disease Screening

2019 ◽  
Vol 37 (02) ◽  
pp. 158-165 ◽  
Author(s):  
Heather Siefkes ◽  
Laura Kair ◽  
Daniel J. Tancredi ◽  
Brian Vasquez ◽  
Lorena Garcia ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Perfusion Index ◽  
Outflow Obstruction ◽  
Critical Congenital Heart Disease ◽  
Healthy Infants ◽  
Optimal Screening ◽  
To Come

Objective To determine if addition of perfusion index (PIx) to oxygen saturation (SpO2) screening improves detection of critical congenital heart disease (CCHD) with systemic outflow obstruction. Study Design We determined screening thresholds for PIx and applied these to a cohort of newborns with and without congenital heart disease (CHD). Results A total of 123 normal and 21 CHD newborns (including five with critical systemic outflow obstruction) were enrolled. Four of these five critical systemic obstruction subjects passed SpO2-based screen. Four out of these five subjects failed PIx-based screen. The sensitivity for detection of systemic obstruction CCHD when compared with healthy infants increased from 20% (95% confidence interval [CI]: 1–72%) with SpO2 screening alone to 80% (95% CI: 28–100%) with combined SpO2-PIx screen. However, 2.44% of normal infants failed PIx screen. Conclusion Addition of PIx to SpO2 screening may detect additional cases of CCHD and further research is necessary to come up with optimal screening thresholds.

scholarly journals Perfusion index in healthy newborns during critical congenital heart disease screening at 24 hours: retrospective observational study from the USA

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017580 ◽  
Author(s):  
Priya Jegatheesan ◽  
Matthew Nudelman ◽  
Keshav Goel ◽  
Dongli Song ◽  
Balaji Govindaswami
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Observational Study ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Selection Method ◽  
Perfusion Index ◽  
Data Selection ◽  
Retrospective Observational Study ◽  
Critical Congenital Heart Disease

ObjectiveTo describe the distribution of perfusion index (PI) in asymptomatic newborns at 24 hours of life when screening for critical congenital heart disease (CCHD) using an automated data selection method.DesignThis is a retrospective observational study.SettingNewborn nursery in a California public hospital with ~3500 deliveries annually.MethodsWe developed an automated programme to select the PI values from CCHD screens. Included were term and late preterm infants who were screened for CCHD from November 2013 to January 2014 and from May 2015 to July 2015. PI measurements were downloaded every 2 s from the pulse oximeter and median PI were calculated for each oxygen saturation screen in our cohort.ResultsWe included data from 2768 oxygen saturation screens. Each screen had a median of 29 data points (IQR 17 to 49). The median PI in our study cohort was 1.8 (95% CI 1.8 to 1.9) with IQR 1.2 to 2.7. The median preductal PI was significantly higher than the median postductal (1.9 vs 1.8, p=0.03) although this difference may not be clinically significant.ConclusionUsing an automated data selection method, the median PI in asymptomatic newborns at 24 hours of life is 1.8 with a narrow IQR of 1.2 to 2.7. This automated data selection method may improve accuracy and precision compared with manual data collection method. Further studies are needed to establish external validity of this automated data selection method and its clinical application for CCHD screening.

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