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Am J Perinatol 2020; 37(02): 158-165
DOI: 10.1055/s-0039-1685445
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Oxygen Saturation and Perfusion Index-Based Enhanced Critical Congenital Heart Disease Screening

Heather Siefkes
1   Department of Pediatrics, University of California, Davis, Sacramento, California
,
Laura Kair
1   Department of Pediatrics, University of California, Davis, Sacramento, California
,
Daniel J. Tancredi
1   Department of Pediatrics, University of California, Davis, Sacramento, California
,
Brian Vasquez
2   School of Medicine, University of California, Davis, Sacramento, California
,
Lorena Garcia
2   School of Medicine, University of California, Davis, Sacramento, California
,
Christa Bedford-Mu
1   Department of Pediatrics, University of California, Davis, Sacramento, California
,
Satyan Lakshminrusimha
1   Department of Pediatrics, University of California, Davis, Sacramento, California
› Author Affiliations Funding The authors would like to thank Department of Pediatrics at University of California, Davis for financially supporting this project.
Further Information

Publication History

22 January 2019

07 March 2019

Publication Date:
19 April 2019 (online)

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Abstract

Objective To determine if addition of perfusion index (PIx) to oxygen saturation (SpO2) screening improves detection of critical congenital heart disease (CCHD) with systemic outflow obstruction.

Study Design We determined screening thresholds for PIx and applied these to a cohort of newborns with and without congenital heart disease (CHD).

Results A total of 123 normal and 21 CHD newborns (including five with critical systemic outflow obstruction) were enrolled. Four of these five critical systemic obstruction subjects passed SpO2-based screen. Four out of these five subjects failed PIx-based screen. The sensitivity for detection of systemic obstruction CCHD when compared with healthy infants increased from 20% (95% confidence interval [CI]: 1–72%) with SpO2 screening alone to 80% (95% CI: 28–100%) with combined SpO2-PIx screen. However, 2.44% of normal infants failed PIx screen.

Conclusion Addition of PIx to SpO2 screening may detect additional cases of CCHD and further research is necessary to come up with optimal screening thresholds.

Keywords

critical congenital heart disease - screening - pulse oximetry - newborns