Screening for Critical Congenital Heart Disease (CCHD)In the United States, about 7,200 (or 18 per 10,000) babies born each year have critical congenital heart defects (CCHDs). Congenital heart defects account for nearly 30% of infant deaths due to birth defects. Babies born with CCHDs usually require surgery or catheter intervention in the first year of life. CCHDs can potentially be detected using pulse oximetry screening, which detects the amount of oxygen in the blood and pulse rate. Pulse oximetry is most likely to detect the following CCHDs: hypoplastic left heart, pulmonary atresia, tetralogy of fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as these and also require treatment soon after birth, but pulse oximetry may not detect these other heart defects. Early screening for CCHD (while still in the hospital) is important because many babies with a heart defect appear healthy at first, due to the ductus arteriosus that has not fully closed. These babies are at risk for having serious complications within the first few days or weeks of life and often require emergency care. Pulse oximetry is a readily available, noninvasive and painless technology that measures the percentage of oxygen saturation of hemoglobin in arterial blood. The screening should be done when the newborn is greater than 24 hours of age, but prior to discharge. It is recommended that the screening be done with the newborn blood spot test. The screening is completed by measuring the preductal (right hand or wrist) and the postductal (either foot) oxygen saturations. Both should be above 95%. If there is a greater than 3% point difference in the readings, the test is repeated up to 2 more times, to verify accuracy, and then the results are reported to the physician for immediate evaluation. Currently, the Texas Pulse Oximetry Project is under way in our state to help standardize and develop guidelines for this routine screening so that it can be implemented on all newborns. Reference: |
