Newborn Pulse Oximetry Screening at a Community Hospital: An 8-Year Experience.

Autor:	Schwartz BN; Division of Cardiology, Children's National Heart Institute bnschwartz@childrensnational.org.; Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia., Hom LA; Division of Cardiology, Children's National Heart Institute., Von Kohorn I; Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.; Division of Neonatal Medicine.; Community Neonatal Associates, Silver Spring, Maryland., Becker J; Division of Cardiology, Children's National Heart Institute.; Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.; Departments of Pediatrics., Cuzzi SS; Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.; Departments of Pediatrics.; Division of Hospital Medicine, Children's National Hospital, Washington, District of Columbia., Clarke SEG; Nursing, Holy Cross Hospital, Silver Spring, Maryland., Kiernan SC; Division of Neonatal Medicine.; Community Neonatal Associates, Silver Spring, Maryland., Martin GR; Division of Cardiology, Children's National Heart Institute.; Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2021 Sep; Vol. 148 (3).
DOI:	10.1542/peds.2020-049847
Abstrakt:	Objectives: To evaluate newborn pulse oximetry screening (POS) outcomes at a large community hospital and the impact of the recommended revised POS algorithm. Methods: A retrospective cohort study was performed to evaluate the results of POS in the well-infant nursery between 2012 and 2020. The POS results were obtained from an electronic platform. Chart review was completed for newborns with failed screens. The recommended revision to POS, no second rescreen, was applied to the data to evaluate screening outcomes. Results: Of the total 65 414 infants admitted to the well-infant nursery during this 8-year period, >99% ( n = 64 780) received POS. Thirty-one infants failed POS (4.6 per 10 000 screened). All infants who failed POS were found to have a disorder, with 12 (39%) having critical congenital heart disease (CCHD), 9 (29%) having non-CCHD requiring further follow-up, and 10 (32%) having noncardiac conditions. One false-negative screen result was identified through the Maryland Department of Health Newborn Screening Follow-up Program. The positive predictive value of POS for those screened was 39% for CCHD, with a specificity of 99.97%. Eliminating the second rescreen in the POS algorithm would have resulted in an additional 5 newborns without CCHD failing POS, increasing the false-positive rate from 0.03% to 0.04%. Conclusions: POS is an effective tool for identifying CCHD and secondary conditions. POS was successfully implemented with few missed screens and was highly specific. Elimination of the second rescreen in the pulse oximetry algorithm would have resulted in a minimal increase in false-positive results and faster evaluation of newborns with CCHD. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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