Pulse oxymetri screening to detect major cardiac malformations.

[Stefan Johansson]

I am interested in pulse oxymetri screening, but we do not perform such screening in our maternity units. Yesterday, a Swedish group published in BMJ, a large screening study including almost 40.000 infants. It seems that the article is available in free full text format here (http://www.bmj.com/cgi/content/full/338/jan08_2/a3037)!

My question to you is... since this method has been discussed for a pretty long time now - do you already now perform pulse oxymetri screening before routine discharge of well babies? If yes, what is your experience?

[Urban Rosenqvist]

We use pulse-oximetry screening in the maternity wards in the hospital of Västerås, Sweden since about half a year or so.

We adopted this method since earlier studies had suggested better sensitivity with a combination of pulse-oximetry and clinical examination than the latter one alone. As mentioned in the article above you also have a better possibility to find non-cardiac problems (causing a lowered oxygen saturation)

As far as I know, in Västerås it has´nt meant an increased amount of echocardiography.
A couple of babies with infection and pulmonary hypertension was discovered this way. I´m not completely updated on cardiac malformations, also I think we have too few patients in this group.

[fcardona]

We don't do it unfortunately - even though we have echo service at our hospital. I guess our level of evidence is still on this level (http://www.ncbi.nlm.nih.gov/pubmed/20195633). Interestingly all children with CHD could be detected clinically in this study, I am not sure if that would apply to many other hospitals around the world...