The role of pulse oximetry in neonatal screening for critical and complex congenital heart defects

Abstract

Background: Timely diagnosis of complex and critical congenital heart defects in neonates can help to avoid fatal complications of their natural history and to establish correct treatment strategies. Therefore, easily available and inexpensive screening methods for their routine diagnostics are important.Aim: To demonstrate the role of pulse oximetry in the diagnosis of complex and critical congenital heart defects.Materials and methods: Forty six neonates aged from 1 to 27 days with congenital heart defects, diagnosed after birth, were included into the study. Their diagnoses were verified by expert echocardiography performed after positive pulse oximetry test or due to unexplainable oxygen dependency and/or clinical manifestation of severe heart failure. The pulse oximetry test was considered positive with SaO2 < 95% in any extremity and the difference between the right hand and foot of above 3%.Results: The pulse oximetry test was positive in all neonates with transposition of the great arteries (n = 5), hypoplastic left heart syndrome (n = 6), total anomalous pulmonary venous collection (n = 2), common arterial trunk (n = 3), pulmonary artery atresia with ventricular septum defect (n = 1). The pulse oximetry test was non-informative in those with obstructive abnormalities of the left heart, such as aortic valve stenosis and aortic coarctation.Conclusion: The pulse oximetry test can be used for routine screening for complex and critical congenital heart defects in neonates.

Keywords

• critical congenital heart disease
• diagnostics
• pulse oximetry test