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

K. Van Naarden Braun; R. Grazel; R. Koppel; S. Lakshminrusimha; J. Lohr; P. Kumar; B. Govindaswami; M. Giuliano; M. Cohen; N. Spillane; P. Jegatheesan; D. McClure; D. Hassinger; O. Fofah; S. Chandra; D. Allen; R. Axelrod; J. Blau; S. Hudome; E. Assing; L. F. Garg

doi:10.1038/jp.2017.105

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

K. Van Naarden Braun, R. Grazel, R. Koppel, S. Lakshminrusimha, J. Lohr, P. Kumar, B. Govindaswami, M. Giuliano, M. Cohen, N. Spillane, P. Jegatheesan, D. McClure, D. Hassinger, O. Fofah, S. Chandra, D. Allen, R. Axelrod, J. Blau, S. Hudome, E. AssingL. F. Garg

Pediatric Cardiology

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1117-1123
Number of pages	7
Journal	Journal of Perinatology
Volume	37
Issue number	10
DOIs	https://doi.org/10.1038/jp.2017.105
State	Published - Oct 1 2017

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© 2017 Nature America, Inc., part of Springer Nature. All rights reserved.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633653

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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., ... Garg, L. F. (2017). Evaluation of critical congenital heart defects screening using pulse oximetry in the neonatal intensive care unit. Journal of Perinatology, 37(10), 1117-1123. https://doi.org/10.1038/jp.2017.105

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 2017, 'Evaluation of critical congenital heart defects screening using pulse oximetry in the neonatal intensive care unit', Journal of Perinatology, vol. 37, no. 10, pp. 1117-1123. https://doi.org/10.1038/jp.2017.105

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abstract = "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.",

author = "{Van Naarden Braun}, K. and R. Grazel and R. Koppel and S. Lakshminrusimha and J. Lohr and P. Kumar and B. Govindaswami and M. Giuliano and M. Cohen and N. Spillane and P. Jegatheesan and D. McClure and D. Hassinger and O. Fofah and S. Chandra and D. Allen and R. Axelrod and J. Blau and S. Hudome and E. Assing and Garg, {L. F.}",

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AU - Lohr, J.

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AU - Govindaswami, B.

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N2 - 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.

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

Abstract

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