Newborn screening for critical congenital heart disease using pulse oximetry

Newborn screening for critical congenital heart disease using pulse oximetry:

The most common congenital disorder in newborns is congenital heart disease (CHD). In the first year of life requiring surgery or catheter- based intervention is known as Critical CHD. Normally in case of infants with critical cardiac lesions, the risk of morbidity and mortality increases when there is a delay in diagnosis and timely referral to a tertiary center with expertise in treating these patients.

Pulse oximetry:  it is a non-invasive method for monitoring a person's oxygen saturation. The application mode of pulse oximetry includes, a sensor device is placed on a thin part of the patient's body, usually a fingertip or earlobe, or in the case of an infant, across a foot. In this process the device passes two wavelengths of light through the body part to a photodetector.  The changing absorbance at each of the wavelength are measured by this, which allowing it to determine the absorbance due to the pulsing arterial blood alone, excluding venous blood, skin, bone, muscle and fat.

Benefits of Screening:

The primary benefit of newborn screening for critical CHD screening with pulse oximetry is timely identification of infants with critical CHD prior to discharge from the birth hospitalization thereby minimizing the morbidity and mortality associated with delayed diagnosis. In a large prospective study, universal screening with pulse oximetry was better at detecting infants with critical CHD compared with physical examination alone.

A secondary benefit of pulse oximetry screening is the identification of conditions other than critical CHD. Common non cardiac causes of hypoxemia that are identified through newborn pulse oximetry screening include sepsis, respiratory distress syndrome (RDS), persistent pulmonary hypertension of the newborn (PPHN), meconium aspiration, hypothermia, hemoglobinopathy, pneumonia, and pneumothorax.