Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine--results from a prospective multicenter study.
Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine--results from a prospective multicenter study.
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DOI：
10.1007/s00431-010-1160-4
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发表时间：
2010-08
影响因子：
3.6
通讯作者：
Schneider, Peter
中科院分区：
文献类型：
--
作者：
Riede, Frank Thomas;Woerner, Cornelia;Daehnert, Ingo;Moeckel, Andreas;Kostelka, Martin;Schneider, Peter
关键词：
脉搏血氧饱和度筛查（POS）被认为是一种有效、无创、廉价的工具，可以早期诊断危重先天性心脏病（cCHD）。我们的目的是检验以下假设：POS 可以减少三级、二级和初级保健中心日常临床常规中 cCHD 的诊断差距。我们在德国萨克森州进行了一项前瞻性多中心试验。 POS 在 24-72 小时内的健康足月和足月后新生儿中进行。如果下肢血氧饱和度 (SpO2) ≤95%，并在 1 小时后得到确认，则进行完整的临床检查和超声心动图检查。当参与医院/我们中心的 POS 后诊断出 cCHD 时，POS 被定义为假阴性。 2006年7月至2008年6月，来自34个机构的42,240名新生儿被纳入其中。 72 名儿童因 POS 前产前诊断 (n = 54) 或 cCHD 临床症状 (n = 18) 而被排除。 795 名新生儿没有接受 POS，主要是由于出生后过早出院（n = 727；91%）。对 41,445 名新生儿进行了 POS 治疗。 14 名儿童中 POS 为真阳性，40 名儿童为假阳性，41,384 名儿童为真阴性，4 名儿童为假阴性（其中 3 名因违反研究方案而被排除）。敏感性、特异性、阳性和阴性预测值分别为77.78%、99.90%、25.93%和99.99%。将POS作为产前诊断、体格检查和临床观察的辅助手段，晚期诊断出cCHD的新生儿比例为4.4%。 POS 可以大大减少 cCHD 的产后诊断差距，并且导致对健康新生儿进行不必要检查的假阳性结果很少见。 POS应在常规产后护理中实施。
Pulse oximetry screening (POS) has been proposed as an effective, noninvasive, inexpensive tool allowing earlier diagnosis of critical congenital heart disease (cCHD). Our aim was to test the hypothesis that POS can reduce the diagnostic gap in cCHD in daily clinical routine in the setting of tertiary, secondary and primary care centres. We conducted a prospective multicenter trial in Saxony, Germany. POS was performed in healthy term and post-term newborns at the age of 24–72 h. If an oxygen saturation (SpO2) of ≤95% was measured on lower extremities and confirmed after 1 h, complete clinical examination and echocardiography were performed. POS was defined as false-negative when a diagnosis of cCHD was made after POS in the participating hospitals/at our centre. From July 2006–June 2008, 42,240 newborns from 34 institutions have been included. Seventy-two children were excluded due to prenatal diagnosis (n = 54) or clinical signs of cCHD (n = 18) before POS. Seven hundred ninety-five newborns did not receive POS, mainly due to early discharge after birth (n = 727; 91%). In 41,445 newborns, POS was performed. POS was true positive in 14, false positive in 40, true negative in 41,384 and false negative in four children (three had been excluded for violation of study protocol). Sensitivity, specificity, positive and negative predictive value were 77.78%, 99.90%, 25.93% and 99.99%, respectively. With POS as an adjunct to prenatal diagnosis, physical examination and clinical observation, the percentage of newborns with late diagnosis of cCHD was 4.4%. POS can substantially reduce the postnatal diagnostic gap in cCHD, and false-positive results leading to unnecessary examinations of healthy newborns are rare. POS should be implemented in routine postnatal care.
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DOI：
10.1136/fn.80.1.f43
发表时间：
1999-01-01
影响因子：
4.4
作者：
Ainsworth, SB;Wyllie, JP;Wren, C
通讯作者：
Wren, C
影响因子：
1.6
作者：
Hoke, TR;Donohue, PK;Byrne, BJ
通讯作者：
Byrne, BJ
影响因子：
8
作者：
Schultz, Amy H.;Localio, A. Russell;Kimmel, Stephen E.
通讯作者：
Kimmel, Stephen E.
影响因子：
5.7
作者：
Brown, K. L.;Ridout, D. A.;Bull, C.
通讯作者：
Bull, C.
影响因子：
3.6
作者：
Hetzel, Patrick G.;Glanzmann, Rene;Buehrer, Christoph
通讯作者：
Buehrer, Christoph