Critical Congenital Heart Disease Screening by Pulse Oximetry in a Neonatal Intensive Care Unit

Critical congenital heart disease (CCHD) screening is effective in asymptomatic late preterm and term newborn infants with a low false positive rate (0.035%). OBJECTIVE: (1) To compare 2817 NICU discharges before and after implementation of CCHD screening; and (2) to evaluate CCHD screening at < 35 weeks gestation. METHODS: collection of results of CCHD screening including preductal and postductal SpO(2) values. RESULTS: During the pre-CCHD screen period, 1247 infants were discharged from the NICU and one case of CCHD was missed. After 3/1/12, 1508 CCHD screens were performed among 1570 discharges and no CCHDs were missed. The preductal and postductal SpO(2) values were 98.8±1.4% and 99±1.3% respectively in preterm and 98.9±1.3% and 98.9±1.4% in term infants. Ten infants had false positive screens (10/1508=0.66%). CONCLUSIONS: Performing universal screening in the NICU is feasible but is associated with a higher false positive rate compared to asymptomatic newborn infants.