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• W2023148077 abstract "We read with great interest Bhola's recent paper on pulse oximetry screening.1 We congratulate the authors and agree wholeheartedly with the conclusions. We have recently published a similar study2 (using the PulseOx protocol3) that examined screening in a UK setting. Both datasets are comparable – from tertiary units over a similar time period. Bhola reported 18 801 babies over 42 months, and we reported 25 859 babies over 40 months. We too found that pulse oximetry (i) is an effective method of identifying both congenital heart defects (CHDs) and important non-cardiac conditions (ii) can be undertaken without additional staff and (iii) does not overload clinical services, particularly echocardiography . However, there are some important differences between the two studies that are worth exploring. Although the baseline pass thresholds were the same (>94%), Bhola used only post-ductal saturations, whereas we used both pre- and post-ductal (additional pass threshold – difference of <3%). Although post-ductal screening takes less time to perform, the difference is minimal (<2 min), and it will miss babies that may be identified by pre- and post-screening.3, 4 Although the number missed in individual studies is small, when scaled up to national populations, this becomes significant. Based on PulseOx study3 data, we estimate, in the UK alone, up to 120 babies/year would be missed using post-ductal compared with pre- and post-screening.3, 4 Timing of screening also differs. Bhola screened between 24 and 72 h, whereas we screened at <24 h (median 7.5). Earlier screening increases false positives (FPs)4 – comparison of our two studies confirms this (FPs 0.15% vs. 0.8%). However, the detection of pathology (including important non-cardiac conditions, which are technically FPs) was also different. Significant pathology was identified in 10/30 (33%) in Bhola's study and in 165/208 (79%) in ours. Earlier screening identifies more babies with pathology (although most have non-cardiac problems) and may detect babies before acute first-day collapse. Bhola's reported sensitivity of 80% for major CHD (as opposed to the more commonly reported critical CHD) is very high compared with the published literature (49% in the PulseOx study3). This may reflect a more selected population following antenatal screening (incidence of major CHD was only 0.8/1000 livebirths) or perhaps more limited ascertainment of false negatives (local cardiac database search only). In conclusion, we completely agree with the main findings and strongly support the call for universal pulse oximetry screening. The precise timing of screening and the algorithm used needs to be carefully considered after reviewing all available evidence." @default.
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• W2023148077 date "2014-10-01" @default.
• W2023148077 modified "2023-10-16" @default.
• W2023148077 title "Newborn pulse oximetry screening" @default.
• W2023148077 cites W1547614038 @default.
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• W2023148077 doi "https://doi.org/10.1111/jpc.12722" @default.
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