Pulse Oximetry Screening for Detecting Critical Congenital Heart Disease in Neonates

Abstract

BackgroundCongenital heart disease (CHD) leads to significant morbidity in the neonatal population and is a crucial disorder behind early infancy death rates. Most have a critical congenital heart defect (Cr CHD) out of all the heart defects found in babies. A subgroup of cardiac anomalies needs surgery or catheter intervention during the neonatal period. Pulse oximetry is a good screening tool to detect cr CHD in neonates. This study aims to assess the effectiveness of pulse oximetry as a screening tool in a rural setting. MethodsThis was a hospital-based prospective observational study. All consecutively born neonates whose parents consented to the study were subjected to pulse oximetry on all four limbs. Their peripheral arterial oxygen saturation was measured on days one, two, and three of life, starting four hours after birth. Babies detected with cyanotic congenital heart disease (CCHD) before birth are not a part of this study. All those with arterial oxygen saturation of less than 95% or a difference of saturation of more than 3% in the upper and lower limbs were considered suspects for Cr CHD and subjected to echocardiography. ResultsAmong 5874 neonates studied, researchers found 164 babies to have significant hypoxemia on pulse oximetry, and 44 CHD were detected on echocardiography within the first three days of life (positive predictive value (PPV) 12.2%). The physician referred all of them to a higher center before further delay. Thirty-four babies with other congenital heart diseases were found using pulse oximetry examination. Also, 108 cases of hypoxemia due to other causes were found and monitored. ConclusionCritical congenital heart diseases are a significant cause of death among neonates and require early diagnosis and emergent medical and surgical management. They are associated with hypoxemia, and this principle can be used to screen them using a pulse oximeter.

Enhancing Neonatal Care: The Vital Role of Pulse Oximetry in the Early Screening of Critical Congenital Heart Diseases and Respiratory Diseases in Rural Areas

“…Because of this, the POS test is an excellent instrument for early detection and prompt referral for such severe illnesses. Some other studies also came to similar conclusions [ 8 , 30 ]. In addition to screening, pulse oximetry is an essential assessment for monitoring the prognosis of newborns receiving care for any of these conditions [ 20 , 22 ].…”

“…After echocardiography, four neonates out of 65 cases who tested positive for hypoxemia were found to have CCHD, yielding an incidence of 9.09% and a PPV of 6.15%. A similar study by Jain et al reported a PPV of 12.2% [ 30 ]. Out of the four CCHD patients with diagnostic echocardiography, two had tetralogy of Fallot, one had transposition of great arteries, and the other had total anomalous pulmonary venous return.…”

“…Although there may not be a portable pulse oximeter available in rural areas, traditional pulse oximeters used in rural community healthcare centers also produce equivalent results. In India, pulse oximeters come in a range of brands and are reasonably priced [ 30 ]. Additionally, this study offers a comparison of the POS values obtained less than 24 hours and more than 24 hours after birth.…”

Enhanced wound recovery after surgery care in patients with total knee arthroplasty: A meta‐analysis

“…These programs have consistently improved patient outcomes, reduced hospital stays and increased satisfaction, enhancing clinical care and healthcare system cost effectiveness. [2][3][4] RAS protocols include a comprehensive approach to surgical care, addressing multiple stages of a patient's journey. Preoperative education commences by emphasizing nutritional optimization and psychological preparation.…”

“…These principles include preoperative counselling, bowel preparation elimination, sedative avoidance, fasting, carbohydrate intake, personalized anaesthesia, controlled intravenous fluid administration, pain control, selective drain and nasogastric tube usage, early postoperative nourishment, prompt urinary catheter removal and mobilization. These programs have consistently improved patient outcomes, reduced hospital stays and increased satisfaction, enhancing clinical care and healthcare system cost effectiveness 2–4 …”