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, Jamie L 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 & 1 others L. F. Garg

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)1117-1123
Number of pages7
JournalJournal of Perinatology
Volume37
Issue number10
DOIs
StatePublished - Oct 1 2017

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Oximetry
Congenital Heart Defects
Neonatal Intensive Care Units
Oxygen
Weaning
Prenatal Diagnosis
Echocardiography
Prospective Studies
Population

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Van Naarden Braun, K., Grazel, R., Koppel, R., Lakshminrusimha, S., Lohr, J. L., Kumar, P., ... 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

Evaluation of critical congenital heart defects screening using pulse oximetry in the neonatal intensive care unit. / Van Naarden Braun, K.; Grazel, R.; Koppel, R.; Lakshminrusimha, S.; Lohr, Jamie L; 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, L. F.

In: Journal of Perinatology, Vol. 37, No. 10, 01.10.2017, p. 1117-1123.

Research output: Contribution to journalArticle

Van Naarden Braun, K, Grazel, R, Koppel, R, Lakshminrusimha, S, Lohr, JL, 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
Van Naarden Braun, K. ; Grazel, R. ; Koppel, R. ; Lakshminrusimha, S. ; Lohr, Jamie L ; 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, L. F. / Evaluation of critical congenital heart defects screening using pulse oximetry in the neonatal intensive care unit. In: Journal of Perinatology. 2017 ; Vol. 37, No. 10. pp. 1117-1123.
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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.",
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AU - Koppel, R.

AU - Lakshminrusimha, S.

AU - Lohr, Jamie L

AU - Kumar, P.

AU - Govindaswami, B.

AU - Giuliano, M.

AU - Cohen, M.

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AU - Jegatheesan, P.

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AU - Allen, D.

AU - Axelrod, R.

AU - Blau, J.

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AU - Assing, E.

AU - Garg, L. F.

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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.

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