AIMS: Critical congenital cardiovascular malformations (CCVMs) require surgical correction during the first month of life, physical examination is unable to detect >50% of affected infants. An oximetry screening has been previously proposed. Our aim was to verify the usefulness and consistency of a pulse oximetry screening for early detection of CCVMs in a small size nursery. METHODS: A single determination of SpO2 was performed on 5292 consecutive apparently healthy newborns, discharged from nursery at a median age of 72 h during the period May 1, 2000 and November 30, 2004. Infants showing signs of congenital heart disease before the screening and those with a prenatal diagnosis were excluded. Cardiac ultrasound was performed on all infants with SpO2< or =95% at >24 h. The accuracy of the screening in identifying CCVMs was assessed by receiver-operating characteristic (ROC) curves analysis. RESULTS: We found 2 (0.038%) true positives, 1 (0.019%) false negative, 1 (0.019%) false positive, and 5288 (99.92%) true negatives. Prevalence of critical CCVMs was 1 in 1764. Clinical follow-up showed no evidence of CCVMs in the negative cases. A pulse-oximetry cut-off value of < or =95% showed 66.7% sensitivity (95% CI: 11.6-94.5), 100% specificity (95% CI: 99.9-100.0), 50% positive predictive value, 100% negative predictive value and AUC of 0.833 (standard error: 0.145) (95% CI: 0.823 to 0.843) in identifying CCVMs. CONCLUSIONS: Our findings indicate that pulse oximetry is a non-invasive and specific screening tool for an early detection of CCVMs, and is easily applicable to a small size nursery.
AIMS: Critical congenital cardiovascular malformations (CCVMs) require surgical correction during the first month of life, physical examination is unable to detect >50% of affected infants. An oximetry screening has been previously proposed. Our aim was to verify the usefulness and consistency of a pulse oximetry screening for early detection of CCVMs in a small size nursery. METHODS: A single determination of SpO2 was performed on 5292 consecutive apparently healthy newborns, discharged from nursery at a median age of 72 h during the period May 1, 2000 and November 30, 2004. Infants showing signs of congenital heart disease before the screening and those with a prenatal diagnosis were excluded. Cardiac ultrasound was performed on all infants with SpO2< or =95% at >24 h. The accuracy of the screening in identifying CCVMs was assessed by receiver-operating characteristic (ROC) curves analysis. RESULTS: We found 2 (0.038%) true positives, 1 (0.019%) false negative, 1 (0.019%) false positive, and 5288 (99.92%) true negatives. Prevalence of critical CCVMs was 1 in 1764. Clinical follow-up showed no evidence of CCVMs in the negative cases. A pulse-oximetry cut-off value of < or =95% showed 66.7% sensitivity (95% CI: 11.6-94.5), 100% specificity (95% CI: 99.9-100.0), 50% positive predictive value, 100% negative predictive value and AUC of 0.833 (standard error: 0.145) (95% CI: 0.823 to 0.843) in identifying CCVMs. CONCLUSIONS: Our findings indicate that pulse oximetry is a non-invasive and specific screening tool for an early detection of CCVMs, and is easily applicable to a small size nursery.
Authors: Patrick G Hetzel; René Glanzmann; Joëlle Günthard; Elisabeth Bruder; Esther Godi; Christoph Bührer Journal: Eur J Pediatr Date: 2006-09-19 Impact factor: 3.183
Authors: Shakila Thangaratinam; Jane Daniels; Andrew K Ewer; Javier Zamora; Khalid S Khan Journal: Arch Dis Child Fetal Neonatal Ed Date: 2007-03-07 Impact factor: 5.747
Authors: Frank Thomas Riede; Cornelia Wörner; Ingo Dähnert; Andreas Möckel; Martin Kostelka; Peter Schneider Journal: Eur J Pediatr Date: 2010-03-01 Impact factor: 3.183
Authors: Cora Peterson; Elizabeth Ailes; Tiffany Riehle-Colarusso; Matthew E Oster; Richard S Olney; Cynthia H Cassell; David E Fixler; Suzan L Carmichael; Gary M Shaw; Suzanne M Gilboa Journal: JAMA Pediatr Date: 2014-04 Impact factor: 16.193
Authors: Maria N Plana; Javier Zamora; Gautham Suresh; Luis Fernandez-Pineda; Shakila Thangaratinam; Andrew K Ewer Journal: Cochrane Database Syst Rev Date: 2018-03-01