Effectiveness of pulse-oximetry in addition to routine neonatal examination in detection of congenital heart disease in asymptomatic newborns
Effectiveness of pulse-oximetry in addition to routine neonatal examination in detection of congenital heart disease in asymptomatic newborns
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DOI：
10.3109/14767058.2014.967674
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发表时间：
2015-01-01
影响因子：
1.8
通讯作者：
Sen, Siddhartha
中科院分区：
文献类型：
--
作者：
Oakley, Juliette L.;Soni, Naharmal B.;Sen, Siddhartha
目的：为了评估的可行性和有效性的脉搏血氧饱和度作为筛查工具在检测危重先天性心脏病（CCHD）在news.Methods：出生于2007年1月1日至2009年12月31日之间的出生后的婴儿有资格。使用Nellcor（R）NPB 40脉搏血氧仪和可重复使用的OXI-A/N饱和探头进行导管后脉搏血氧测定。饱和度>= 95%视为正常。如果饱和度为595%，则进行超声心动图检查。区域儿科心脏病数据库和死亡记录确定婴儿后来诊断为CCHD.Results：6329/9613合格的婴儿进行了研究和脉搏血氧测定，平均年龄为28小时（范围6-72小时）。14个婴儿的饱和度为595%。7/14例婴儿被诊断为CCHD; 4/7例无临床体征。在其余7名婴儿中，3名患有非危重但严重的CHD，4名患有未确诊的呼吸道疾病或败血症。所有低饱和度的婴儿都有可识别的病理。一名饱和度正常的婴儿后来被诊断为大动脉转位。诊断胎儿不适的敏感性和特异性分别为93.3%和100%，诊断CCHD的敏感性和特异性分别为87.5%和99.8%。仅临床检查将错过4/7（57%）thes.Conclusion：脉搏血氧饱和度是安全的，可接受的，非侵入性和有效的。我们的研究支持常规使用脉搏血氧仪作为新生儿检查的一部分。
Objective: To assess the feasibility and effectiveness of pulse-oximetry as a screening tool in the detection of critical congenital heart disease (CCHD) in newborns.Methods: Post-natal babies born between 01/01/2007-31/12/2009 were eligible. Post-ductal pulse-oximetry was performed using Nellcor (R) NPB 40 pulse oximeter with reusable OXI-A/N saturation probe. Saturations >= 95% were deemed normal. If saturations were 595%, an echocardiogram was done. The regional paediatric cardiology database and death records identified babies later diagnosed with CCHD.Results: 6329/9613 eligible babies were studied and pulse-oximetry was performed at a mean age of 28 hours (range 6-72 hours). Fourteen babies had saturations 595%. CCHD was diagnosed in 7/14 babies; 4/7 had no clinical signs. Of the remaining 7 babies, 3 had non-critical but significant CHD and 4 had an undiagnosed respiratory illness or sepsis. All babies with low saturations had identifiable pathologies. One baby with normal saturations was later diagnosed with transposition of the great arteries. The sensitivity and specificity of identifying an unwell baby was 93.3% and 100% respectively; the sensitivity and specificity of identifying CCHD was 87.5% and 99.8% respectively. Clinical examination alone would have missed 4/7 (57%) of these.Conclusion: Pulse-oximetry is safe, acceptable, non-invasive and effective. Our study supports the routine use of pulse oximetry as part of the newborn check.