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Open Access Publications from the University of California

Evaluation of critical congenital heart defects screening using pulse oximetry in the neonatal intensive care unit.

  • Author(s): Van Naarden Braun, K
  • Grazel, R
  • Koppel, R
  • Lakshminrusimha, S
  • Lohr, J
  • Kumar, P
  • Govindaswami, B
  • Giuliano, M
  • Cohen, M
  • Spillane, N
  • Jegatheesan, P
  • McClure, D
  • Hassinger, D
  • Fofah, O
  • Chandra, S
  • Allen, D
  • Axelrod, R
  • Blau, J
  • Hudome, S
  • Assing, E
  • Garg, LF
  • et al.

OBJECTIVE:To evaluate the implementation of early screening for critical congenital heart defects (CCHDs) in the neonatal intensive care unit (NICU) and potential exclusion of sub-populations from universal screening. STUDY DESIGN:Prospective evaluation of CCHD screening at multiple time intervals was conducted in 21 NICUs across five states (n=4556 infants). RESULTS:Of the 4120 infants with complete screens, 92% did not have prenatal CHD diagnosis or echocardiography before screening, 72% were not receiving oxygen at 24 to 48 h and 56% were born ⩾2500 g. Thirty-seven infants failed screening (0.9%); none with an unsuspected CCHD. False positive rates were low for infants not receiving oxygen (0.5%) and those screened after weaning (0.6%), yet higher among infants born at <28 weeks (3.8%). Unnecessary echocardiograms were minimal (0.2%). CONCLUSION:Given the majority of NICU infants were ⩾2500 g, not on oxygen and not preidentified for CCHD, systematic screening at 24 to 48 h may be of benefit for early detection of CCHD with minimal burden.

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