Rethinking Pulse Oximetry Screening in the Level-IV Neonatal Intensive Care Unit

Author:

Schwartz Bryanna N.12ORCID,Hom Lisa A.12,Revenis Mary E.23,Martin Gerard R.12

Affiliation:

1. Division of Cardiology, Children's National Heart Institute, Children's National Hospital, Washington, District of Columbia

2. Department of Pediatrics, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

3. Division of Neonatology, Children's National Hospital, Washington, District of Columbia

Abstract

Objective This study aimed to evaluate the outcomes of newborn pulse oximetry screening in a level IV, tertiary care neonatal intensive care unit (NICU). Study Design This is a retrospective cohort study of neonates who received newborn pulse oximetry screening after being admitted to a single-center, level-IV NICU between 2014 and 2021. Neonates with known critical congenital heart disease were excluded from the study. Results Of the 4,493 neonates who had pulse oximetry screening, there were three positive screens (fail rate of 0.067%, 0.67 per 1,000 screened). The average age of screening was 818 hours. There were no positive screens of newborns who were admitted during their initial birth hospitalization and were screened while off oxygen. There were no new diagnoses of critical congenital heart disease (true positives) and there were no known false negatives. Conclusion The results bring into question whether pulse oximetry screening with the current AAP-endorsed algorithm should be re-evaluated for a level-IV NICU at a children's hospital. However, the results may not be generalizable to other NICU's where echocardiography and prenatal echocardiograms are not as readily available. Key Points

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

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