August 30, 2011
Dennis Davidson, MD
The November issue of Pediatrics reports a strategy for screening for congenital heart disease via a test called pulse oximetry, which measures blood oxygen. The report—published online August 22—is endorsed by the American Academy of Pediatrics, the American College of Cardiology Foundation and the American Heart Association.
I support these recommendations. In fact, the neonatal service at Cohen Children’s Medical Center of New York has been using pulse oximetry screening since 2003, when neonatologist Robert Koppel, MD, published an early study demonstrating its usefulness in detecting critical congenital heart malformations before a baby could be discharged from the regular newborn nursery.
Pulse oximetry is a rapid, easy crib-side test that is noninvasive, extremely inexpensive, and completely safe way to detect a newborn’s oxygen saturation. The test is done just before the routine blood test taken from the baby’s heel to test for a variety of treatable newborn conditions that may be extremely harmful.
Pulse oximetry is not a perfect test, but it is much better than the current standards of practice, especially since hospital discharges of the mother and baby occur sometimes as early as 24 to 36 hours after birth. Pulse oximetry screening can help prevent the newly born with an undiagnosed heart malformation from going home and developing shock that can lead to death or permanent brain and other organ injury, when there could have been corrective cardiovascular surgery shortly after birth.