Pulse Oximetry Testing for Screening tor CongenitaI Heart Defects in Newborns: A Literature Review of the Effectiveness and Accuracy

Presenters

Bethany Teixeira, Cedarville University
Amanda Custer, Cedarville University

Type of Submission

Poster

Campus Venue

Dixon Ministry Center, Alumni Hall

Location

Cedarville, OH

Start Date

4-10-2013 1:00 PM

End Date

4-10-2013 5:00 PM

Comments

Abstract:

Purpose: To examine If pulse oximetry testing Is a practical and reliable method to screen for congenital heart defects (CHD) and increase the early detection of complex CHD In asymptomatic newborns. Design Findings were searched using Medline and Pubmed with the key words "pulse oximetry", "newborn", and "congenital heart disease". Methods: A literature review was conducted and eight articles that pertained to newborns, pulse oximetry, and CHD were carefully analyzed. An RN from Miami Valley Hospital in Dayton, Ohio, was interviewed regarding their specific policies about this topic. Findings: Pulse oximetry testing has a sensitivity of 76.5 percent and specificity of 99.9 percent. All articles confirmed the test is moderately accurate for CHD detection and high for a negative screen for CHD. Studies in the articles used both the hand and foot for screening. A positive test cut off 02 rage of 94 percent -96 percent was reported in most articles with the majority of 95 percent. Screenings were performed after birth either at 24 hrs, 6-12 hrs, or discharge. Type 2 errors were noted and decreased when screened 24 hours after birth. A retest was performed if the test was under the 02 saturation cut off, a physician was consulted, and an echocardiogram was ordered. Conclusions: It has been determined that using a pulse oximetry is a simple, non-invasive, and cost-effective test that increases the early detection of critical CHDs and thus should be implemented on all newborns. Clinical Relevance: The test should be performed after the infant is 24-hours-old and can be applied to either the hand or foot. In order to receive an accurate reading, the pulse oximetry should be applied until threshold Is reached. If the saturation Is above 95 percent the test will be charted negative for CHD. However, if the saturation is below 95 percent then it should be retested and if it is still below 95 percent, further evaluation with an echocardiogram and clinical examination by a physician is required.

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