Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis

@article{Thangaratinam2012PulseOS,
  title={Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis},
  author={Shakila Thangaratinam and Kiritrea Brown and Javier Zamora and Khalid Saeed Khan and Andrew K Ewer},
  journal={The Lancet},
  year={2012},
  volume={379},
  pages={2459-2464}
}

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TLDR
Pulse oximetry is a sensitive screening tool for detecting major CHDs in Indian newborns and adds significant value to the current practice of using clinical examination as a sole screening tool as well as specificity, which was much lower in this study.
Pulse oximetry screening for critical congenital heart disease - Experience in a public hospital in India
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Pulse oximetry has a high sensitivity, specificity, and negative predictive value for detection of CCHD in newborn infants and PPI is a good predictor of systemic hypoperfusion in CCHd.
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References

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Accuracy of pulse oximetry in screening for congenital heart disease in asymptomatic newborns: a systematic review
TLDR
Pulse oximetry was found to be highly specific tool with very low false positive rates to detect congenital heart disease in asymptomatic newborns and large, well-conducted prospective studies are needed to assess its sensitivity with higher precision.
Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness.
TLDR
Pulse oximetry is a simple, safe, feasible test that is acceptable to parents and staff and adds value to existing screening and is likely to identify cases of critical CHDs that would otherwise go undetected and be cost-effective given current acceptable thresholds.
Indications and limitations for a neonatal pulse oximetry screening of critical congenital heart disease
TLDR
The findings indicate that pulse oximetry is a non-invasive and specific screening tool for an early detection of CCVMs, and is easily applicable to a small size nursery.
Role of Pulse Oximetry in Examining Newborns for Congenital Heart Disease: A Scientific Statement from the AHA and AAP
TLDR
Routine pulse oximetry performed after 24 hours in hospitals that have on-site pediatric cardiovascular services incurs very low cost and risk of harm, and this practice should become standard of care in the routine assessment of the neonate.
Combining Pulse Oximetry and Clinical Examination in Screening for Congenital Heart Disease
TLDR
It is concluded that combining pulse oximetry and clinical examination can enhance the clinician’s ability to detect life-threatening CHD in a timely manner and should become a part of the discharge plan for every newborn.
Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39 821 newborns
TLDR
Introducing pulse oximetry screening before discharge improved total detection rate of duct dependent circulation to 92% and suggests that such screening will be cost effective long term.
Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine—results from a prospective multicenter study
TLDR
POS can substantially reduce the postnatal diagnostic gap in cCHD, and false-positive results leading to unnecessary examinations of healthy newborns are rare, so POS should be implemented in routine postnatal care.
Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis.
TLDR
Pulse oximetry is a promising alternative newborn screening strategy but further evaluation is needed to obtain more precise estimates of test performance and to inform optimal timing, diagnostic and management strategies.
The contribution of pulse oximetry to the early detection of congenital heart disease in newborns
TLDR
Postductal pulse-oximetric screening in the first few days of life is an effective means for detecting cyanotic congenital heart disease in otherwise healthy newborns.
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