Research Shows Pulse Oximetry Viable Screening Tool for Infants with Suspected Congenital Heart Disease

   According to research presented at the American Academy of Pediatrics National Conference and Exhibition (NCE) in Boston, pulse oximetry, a readily available, non-invasive procedure that measures the amount of oxygen in the bloodstream, can be used as a screening tool to detect critical congenital heart disease (CCHD) in infants.

   The U.S. Department of Health and Human Services recently added pulse oximetry to the list of core screening standards; however, no research had been conducted into the availability of these devices or their frequency of use.

Daniel J. Beissel, MD, Elizabeth M. Goetz, MD, and John S. Hokanson, MD, of the University of Wisconsin School of Medicine and Public Health/American Family Children's Hospital, at Madison, surveyed nurse managers and administrators at 88 of the 99 Wisconsin hospitals that routinely perform deliveries. All responding hospitals had pulse oximetry available in the nursery, but only 28.4% (representing one-third of all newborns in the state) routinely used the device to screen for CCHD.

   When a newborn is suspected of having CHD because of low oxygen saturations, the gold standard for diagnosis of CHD is echocardiography.  However, echocardiography is not immediately available in all settings in which newborns are delivered. The researchers’ data showed that same-day echocardiography was available at only 37.5% of the responding hospitals. More than 26% of births occurred in a facility where same-day neonatal echocardiography was not available, with the average distance to a higher-level care facility of choice being 53.1 miles. However, 78.2% of responding hospitals without neonatal echocardiography have adult echocardiography available.

   As noted, all responding hospitals had pulse oximetry available in the nursery.

"Although the use of pulse oximetry is a relatively new tool in screening for critical congenital heart disease, its use is expanding rapidly," said Dr. Beissel, lead author on the study. "The implementation of pulse oximetry is likely to expand further as more and more states pass legislation requiring this type of screening in all newborns."