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1.
Eur J Pediatr ; 177(5): 683-689, 2018 May.
Article in English | MEDLINE | ID: mdl-29404717

ABSTRACT

A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of < 1 h (range < 1-9 h) after delivery. Data was stratified by CCHD diagnosis and analysed according to the three different admission Pulsox thresholds, ≤ 90, ≤ 92 and ≤ 95%. Of the 276 neonates studied, 208 were clinically well at admission, with no co-morbidities, gestation > 34 weeks and birth weight > 1.8 kg. A statistically significant increase in the proportion with low admission saturations was seen using ≤ 95% saturation threshold (72% (95% CI 66-78)) compared to ≤ 92% (52% (95% CI 46-59)) and ≤ 90% (46% (95% CI 39-52)). Sub-group analysis found the proportion of neonates with low saturations varied according to the specific CCHD diagnosis with only 20-42% of neonates with aortic stenosis, coarctation of the aorta and pulmonary stenosis having saturations ≤ 95%. CONCLUSION: The proportion of neonates with low admission oxygen saturation varied by CCHD diagnosis with those without critically reduced pulmonary blood flow not having low admission saturations, in general, even using the ≤ 95% threshold which had the highest proportions of abnormal saturations. This data may assist developing Pulsox screening policies. What is Known: • The addition of pulse oximetry (Pulsox) screening to the routine newborn examination increases the sensitivity of CCHD detection. Pulsox screening is also highly specific for CCHD in asymptomatic neonates, with low false-positive rates. • Early diagnosis of CCHD improves patient outcomes in relation to both morbidity and mortality. What is New: • The proportion of affected infants with an abnormal Pulsox result varies by CCHD diagnosis and screening threshold. In our study using the ≤ 95% threshold gave the highest proportion of neonates with abnormal saturations at admission. • In general, Pulsox yield of abnormal results is low for CCHD diagnoses not associated with critically reduced pulmonary blood flow; however, increasing the Pulsox threshold increased the proportion of infants with an abnormal result.


Subject(s)
Heart Defects, Congenital/diagnosis , Neonatal Screening/methods , Oximetry/methods , Databases, Factual , Humans , Infant, Newborn , Retrospective Studies
2.
J Paediatr Child Health ; 47(10): 693-7, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21449897

ABSTRACT

AIM: The study aims to investigate pulse oximetry measurements from a 'blue' pulse oximeter sensor against measurements from a 'standard' pulse oximeter sensor in newly born infants. METHODS: Immediately after birth, both sensors were attached to the infant, one to each foot. SpO2 measurements were recorded simultaneously from each sensor for 10 min. Agreement between pairs of SpO2 measurements were calculated using Bland-Altman analysis. RESULTS: Thirty-one infants were studied. There was good correlation between simultaneous SpO2 measurements from both sensors (r² = 0.75). However, the mean difference between 'blue' and 'standard' sensors was -1.6%, with wide 95% limits of agreement +18.4 to -21.6%. The range of mean difference between sensors from each infant ranged from -20 to +20. CONCLUSION: The mean difference between the blue and standard sensor SpO2 measurements is not clinically important.


Subject(s)
Oximetry/instrumentation , Oxygen/blood , Humans , Infant, Newborn , Resuscitation
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