For a study, researchers sought to conduct a retrospective analysis of a substantial clinical application of a fast-screening tool for congenital heart disease employing a combined pulse oximeter (POX) and congenital heart disease (CHD). Every newborn at a large maternity hospital had auscultation and a POX test within 24 hours of birth. When an abnormal heart murmur or SpO2 level was identified, an echocardiogram was used to confirm the diagnosis of CHD. Between January 1, 2018, and December 31, 2019, there were 44,147 live births at the hospital under study, and 498 possible CHD were found in 27 newborns using POX screening and 471 with cardiac auscultation. In 458 newborns, echocardiography was used to confirm the diagnosis. This result revealed an overall diagnosis rate of 92.0%. Cardiac auscultation detected 438 (95.6%) of the CHD cases. However, only 20 (4.4%) of the cases were detected by POX. Interestingly, neither the auscultation test nor the POX screening revealed any cases of CHD. Auscultation was used to identify the majority of common types of CHD, although POX was more effective in identifying rare and dangerous cases. Just 74.07% of the POX test results were positive, with a positive predict value (PPV). However, the POX addition improved screening performance overall and produced a 100% NPV. However, the PPV and negative predictive value (NPV) of auscultation were quite high (92.99 and 99.95%, respectively). With the help of data gathered 6 months after the research period, investigators further validated the findings. Their research showed that adding pulse oximetry to conventional cardiac auscultation might be an accurate and useful screening for early CHD identification in newborns in broad clinical practice.
Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03540-7
