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Utility of pulse-oximetry screening in newborns with nonductus-dependent cyanotic congenital heart defects: A reason to alarm?


1 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi; Pt BD Sharma University of Health Sciences, Rohtak, Haryana, India

Correspondence Address:
Dr. Anita Saxena
Vice Chancellor, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana - 124 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_9_22

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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 41-43

 

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Objectives : We aimed to compare the performance of pulse-oximetry screening in detecting nonductus-dependent cyanotic congenital heart defects (CCHDs). Methods : In a prospective cross-sectional study, we recorded post ductal saturation of neonates (<48 h old) born at a community hospital in northern India. Subsequently, all underwent clinical examination and echocardiogram by a trained cardiologist. A saturation <95% was considered a “failed” screen. Results : Ten neonates were identified to have nonductus-dependent CCHD on echocardiogram, five of whom had passed pulse-oximetry screen. This translated to a sensitivity of 50% (95% confidence interval [CI] 23.7%–76.3%) and a positive predictive value of 0.08 (95% CI 0.03–0.2), both of which were significantly less compared to that in ductus-dependent congenital heart defect. Conclusions : Up to half of the nonductus-dependent CCHD may be missed if screened only using pulse oximetry. Parents should not be reassured regarding the absence of CCHD only based on a “pass” in pulse-oximetry screening.






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1 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi; Pt BD Sharma University of Health Sciences, Rohtak, Haryana, India

Correspondence Address:
Dr. Anita Saxena
Vice Chancellor, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana - 124 001
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_9_22

Rights and Permissions

Objectives : We aimed to compare the performance of pulse-oximetry screening in detecting nonductus-dependent cyanotic congenital heart defects (CCHDs). Methods : In a prospective cross-sectional study, we recorded post ductal saturation of neonates (<48 h old) born at a community hospital in northern India. Subsequently, all underwent clinical examination and echocardiogram by a trained cardiologist. A saturation <95% was considered a “failed” screen. Results : Ten neonates were identified to have nonductus-dependent CCHD on echocardiogram, five of whom had passed pulse-oximetry screen. This translated to a sensitivity of 50% (95% confidence interval [CI] 23.7%–76.3%) and a positive predictive value of 0.08 (95% CI 0.03–0.2), both of which were significantly less compared to that in ductus-dependent congenital heart defect. Conclusions : Up to half of the nonductus-dependent CCHD may be missed if screened only using pulse oximetry. Parents should not be reassured regarding the absence of CCHD only based on a “pass” in pulse-oximetry screening.






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