Rethinking Pulse Oximetry Screening in the Level-IV Neonatal Intensive Care Unit

Bryanna N. Schwartz; Lisa A. Hom; Mary E. Revenis; Gerard R. Martin

doi:10.1055/s-0042-1757350

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2022; 39(S 01): S49-S51
DOI: 10.1055/s-0042-1757350

Original Article

Rethinking Pulse Oximetry Screening in the Level-IV Neonatal Intensive Care Unit

Authors

Bryanna N. Schwartz

¹Division of Cardiology, Children's National Heart Institute, Children's National Hospital, Washington, District of Columbia

²Department of Pediatrics, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia
Lisa A. Hom

¹Division of Cardiology, Children's National Heart Institute, Children's National Hospital, Washington, District of Columbia

²Department of Pediatrics, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia
Mary E. Revenis

²Department of Pediatrics, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

³Division of Neonatology, Children's National Hospital, Washington, District of Columbia
Gerard R. Martin

¹Division of Cardiology, Children's National Heart Institute, Children's National Hospital, Washington, District of Columbia

²Department of Pediatrics, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

Abstract

Objective This study aimed to evaluate the outcomes of newborn pulse oximetry screening in a level IV, tertiary care neonatal intensive care unit (NICU).

Study Design This is a retrospective cohort study of neonates who received newborn pulse oximetry screening after being admitted to a single-center, level-IV NICU between 2014 and 2021. Neonates with known critical congenital heart disease were excluded from the study.

Results Of the 4,493 neonates who had pulse oximetry screening, there were three positive screens (fail rate of 0.067%, 0.67 per 1,000 screened). The average age of screening was 818 hours. There were no positive screens of newborns who were admitted during their initial birth hospitalization and were screened while off oxygen. There were no new diagnoses of critical congenital heart disease (true positives) and there were no known false negatives.

Conclusion The results bring into question whether pulse oximetry screening with the current AAP-endorsed algorithm should be re-evaluated for a level-IV NICU at a children's hospital. However, the results may not be generalizable to other NICU's where echocardiography and prenatal echocardiograms are not as readily available.

Key Points

Pulse oximetry has been shown to be effective in decreasing delayed diagnosis of critical congenital heart disease (CCHD); however, there are limited prior studies on newborn pulse oximetry in the NICU.
In our study of over 4,000 neonates admitted to a level IV tertiary care NICU, there were no true positives (no new diagnoses of CCHD).
Special considerations may be needed for pulse oximetry screening in the NICU setting.

Keywords

pulse oximetry screening - NICU - newborn CCHD - brief resolved unexplained event

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Referenzen

References
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