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Pulse Oximetry Screening Promising for Heart Defects

Method linked to lower risk of discharging infants with undiagnosed duct dependent circulation

FRIDAY, Jan. 9 (HealthDay News) -- Using pulse oximetry to screen babies in maternity units significantly improved detection of duct dependent circulation before the babies were discharged, with evidence suggesting such screenings were cost-effective, according to research published online Jan. 8 in BMJ.

Anne de-Wahl Granelli, of the Queen Silvia Children's Hospital in Goteborg, Sweden, and colleagues analyzed data from 39,821 babies born in a period between 2004 and 2007. The researchers compared the rate of detection of duct dependent circulation in the West Gotaland region with the rate in regions not using pulse oximetry screening. They used a new-generation device that measured functional oxygen saturation in the right hand (preductally) and a foot (postductally).

A combination of physical examination and pulse oximetry had a detection rate of 82.8 percent for duct dependent heart disease, the researchers report. The false-positive rate for pulse oximetry was only 0.17 percent, and many of these cases had other pathology. Taking into account babies presenting clinically, 92 percent of babies with duct dependent circulation in the region were diagnosed before discharge, the report indicates. The risk of leaving the hospital with undiagnosed duct dependent circulation was higher in the other regions compared to West Gotaland (relative risk 3.36), the investigators found.

"Universal pulse oximetry screening of all newborn infants seems to be a low-risk, low-cost strategy for improving the detection of critical congenital heart disease. Serious consideration should be given to its introduction wherever neonatal cardiac surgery is available," writes Keith J. Barrington, of the Universite de Montreal in Quebec, Canada, in an accompanying editorial.

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