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Girdhar A, Ewer AK. Pulse Oximetry Screening for Critical Congenital Heart Defects in Newborn Babies. Crit Care Nurs Clin North Am 2024; 36:99-110. [PMID: 38296378 DOI: 10.1016/j.cnc.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Pulse oximetry screening (POS) was first described over 20 years ago. However, in recent years, major clinical trials have demonstrated consistent test accuracy for the detection of critical congenital heart defects (CCHD). International uptake of POS has progressed well over the last 10 years with most major high-income countries now recommending screening. This review describes the evidence base which has led to this, the current debate regarding choice of screening algorithm, and the future areas for further research.
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Affiliation(s)
- Anurag Girdhar
- Department of Neonatology, Birmingham Women's Hospital NHS Trust, Birmingham, United Kingdom
| | - Andrew K Ewer
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Abstract
The possibility of pulse oximetry screening (POS) for congenital heart defects was first described over 20 years ago. Since then, an accumulation of research evidence and clinical practice experience has established POS as an important test to detect critical congenital heart defects (CCHDs). POS meets the criteria for universal screening and professional bodies around the globe have recommended universal POS. Many countries have already adopted POS while several others are working towards its implementation. In low and low-middle-income countries (LLMIC), POS has the additional potential for reducing morbidity and mortality from neonatal sepsis. This review summarises the evidence for POS and looks at current global uptake and different approaches to the implementation of POS.
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Affiliation(s)
- Asad Abbas
- Department of Neonatology, Birmingham Women's Hospital NHS Trust, Birmingham, United Kingdom.
| | - Andrew K Ewer
- Department of Neonatology, Birmingham Women's Hospital NHS Trust, Birmingham, United Kingdom; Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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El Idrissi Slitine N, Bennaoui F, Sable CA, Martin GR, Hom LA, Fadel A, Moussaoui S, Inajjarne N, Boumzebra D, Mouaffak Y, Younous S, Boukhanni L, Maoulainine FMR. Pulse Oximetry and Congenital Heart Disease Screening: Results of the First Pilot Study in Morocco. Int J Neonatal Screen 2020; 6:53. [PMID: 33123634 PMCID: PMC7570348 DOI: 10.3390/ijns6030053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/26/2020] [Indexed: 11/17/2022] Open
Abstract
Congenital heart disease (CHD) is the most common congenital malformation. Diagnosis of critical congenital heart disease (CCHD), the most severe type of congenital heart disease, in a newborn may be difficult. The addition of CCHD screening, using pulse oximetry, to clinical assessment significantly improves the rate of detection. We conducted a pilot study in Morocco on screening neonates for critical congenital heart disease. This study was conducted in the maternity ward of Mohammed VI University Hospital of Marrakesh, Morocco, and included asymptomatic newborns delivered between March 2019 and January 2020. The screening of CCHD was performed by pulse oximetry measuring the pre- and post-ductal saturation. Screening was performed on 8013/10,451 (76.7%) asymptomatic newborns. According to the algorithm, 7998 cases passed the screening test (99.82%), including one inconclusive test that was repeated an hour later and was normal. Fifteen newborns failed the screening test (0.18%): five CCHD, five false positives, and five CHD but non-critical. One false negative case was diagnosed at 2 months of age. Our results encourage us to strengthen screening for CCHD by adding pulse oximetry to the routine newborn screening panel.
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Affiliation(s)
- Nadia El Idrissi Slitine
- Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco; (F.B.); (A.F.); (S.M.); (N.I.); (F.M.R.M.)
- Laboratory Childhood, Health and Development, Marrakesh Medical School, Cadi Ayyad University, Marrakech 40000, Morocco; (Y.M.); (S.Y.)
| | - Fatiha Bennaoui
- Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco; (F.B.); (A.F.); (S.M.); (N.I.); (F.M.R.M.)
- Laboratory Childhood, Health and Development, Marrakesh Medical School, Cadi Ayyad University, Marrakech 40000, Morocco; (Y.M.); (S.Y.)
| | - Craig A Sable
- Children's National Heart Institute, George Washington University School of Medicine, Washington, DC 20010, USA; (C.A.S.); (G.R.M.); (L.A.H.)
| | - Gerard R Martin
- Children's National Heart Institute, George Washington University School of Medicine, Washington, DC 20010, USA; (C.A.S.); (G.R.M.); (L.A.H.)
| | - Lisa A Hom
- Children's National Heart Institute, George Washington University School of Medicine, Washington, DC 20010, USA; (C.A.S.); (G.R.M.); (L.A.H.)
| | - Amal Fadel
- Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco; (F.B.); (A.F.); (S.M.); (N.I.); (F.M.R.M.)
| | - Soufiane Moussaoui
- Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco; (F.B.); (A.F.); (S.M.); (N.I.); (F.M.R.M.)
- Laboratory Childhood, Health and Development, Marrakesh Medical School, Cadi Ayyad University, Marrakech 40000, Morocco; (Y.M.); (S.Y.)
| | - Nadir Inajjarne
- Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco; (F.B.); (A.F.); (S.M.); (N.I.); (F.M.R.M.)
| | - Drissi Boumzebra
- Cardio-Vascular Surgery Center, Arazzi Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco;
| | - Youssef Mouaffak
- Laboratory Childhood, Health and Development, Marrakesh Medical School, Cadi Ayyad University, Marrakech 40000, Morocco; (Y.M.); (S.Y.)
- Pediatric Intensive Care, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco
| | - Said Younous
- Laboratory Childhood, Health and Development, Marrakesh Medical School, Cadi Ayyad University, Marrakech 40000, Morocco; (Y.M.); (S.Y.)
- Pediatric Intensive Care, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco
| | - Lahcen Boukhanni
- Gyneco-Obstetrical Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco;
| | - Fadl Mrabih Rabou Maoulainine
- Neonatal Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital, Marrakech 40000, Morocco; (F.B.); (A.F.); (S.M.); (N.I.); (F.M.R.M.)
- Laboratory Childhood, Health and Development, Marrakesh Medical School, Cadi Ayyad University, Marrakech 40000, Morocco; (Y.M.); (S.Y.)
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Ewer AK. Pulse Oximetry Screening for Critical Congenital Heart Defects: A Life-Saving Test for All Newborn Babies. Int J Neonatal Screen 2019; 5:14. [PMID: 33072974 PMCID: PMC7510192 DOI: 10.3390/ijns5010014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/11/2019] [Indexed: 11/16/2022] Open
Abstract
Congenital heart defects (CHD) are the commonest congenital malformations and remain a major cause of neonatal mortality and morbidity in the developed world [...]
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Affiliation(s)
- Andrew K Ewer
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK;
- Neonatal Unit, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham B15 2TG, UK
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