Feasibility of Pulse Oximetry Screening for Critical Congenital Heart Disease at 2643-Foot Elevation

• Published in: Pediatric cardiology Vol. 34; no. 8; pp. 1803 - 1807
• Main Authors: Han, Lucy M., Klewer, Scott E., Blank, Karin M., Seckeler, Michael D., Barber, Brent J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2013; Springer
• Subjects: Altitude; Cardiac Surgery; Cardiology; Critical Illness; False Positive Reactions; Feasibility Studies; Female; Genetic disorders; Gestational Age; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - metabolism; Heart diseases; Humans; Infant, Newborn; Infants (Newborn); Male; Medical screening; Medicine; Medicine & Public Health; Neonatal Screening - methods; Original Article; Oximetry; Oximetry - methods; Patient monitoring equipment; Reproducibility of Results; Vascular Surgery; Arizona; Newborn; Pulse oximetry; Critical congenital heart disease; Altitude
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-013-0716-2

To evaluate the feasibility of implementing a pulse oximetry screening protocol at a city of mild elevation with a specific focus on the false-positive screening rate. Pulse oximetry screening was performed according to the proposed guidelines endorsed by the American Academy of Pediatrics at a center in Tucson, AZ, at an elevation of 2,643 ft (806 m). During a 10-month period in 2012, 1069 full-term asymptomatic newborns were screened ≥24 h after birth. The mean preductal oxygen saturation was 98.5 ± 1.3 % (range 92–100 %), and the mean postductal oxygen saturation was 98.6 ± 1.3 % (range 94–100 %). Of 1,069 patients screened, 7 were excluded secondary to protocol violations, and 1 screened positive. An echocardiogram was performed on the newborn with the positive screen, and it was normal with the exception of right-to-left shunting across a patent foramen ovale. The false-positive rate was 1/1,062 or 0.094 %. The pulse oximetry screening guidelines recommended by the American Academy of Pediatrics are feasible at an elevation of 2,643 ft (806 m) with a low false-positive rate. Adjustments to the protocol are not required for centers at elevations ≤2,643 ft. Future studies at greater elevations are warranted.