Abstract
Objective:
Screening for critical congenital heart disease (CCHD) using pulse oximetry has been endorsed by the American Academy of Pediatrics and the American Heart Association. The recommended screening requires two saturation readings. We sought to determine the incidence of undetected CCHD in Tennessee for the 2 years following implementation of an algorithm that assigned an immediate pass to a single lower extremity saturation of 97% or higher.
Study Design:
State Genetic Screening records and reports of missed cases from the Tennessee Initiative for Perinatal Quality Care were used to determine if CCHD cases were missed by the new screening algorithm.
Result:
During the study, 232 infants failed the screen with 51 or 22% true positives, 13 infants had undetected CCHD (10 coarctations, 2 anomalous veins and 1 Tetralogy of Fallot).
Conclusion:
This approach eliminated over 150 000 pulse oximetry determinations in Tennessee without affecting the ability of pulse oximetry to detect CCHD before discharge.
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Acknowledgements
We wish to acknowledge the work of the Cardiologists of Tennessee who formed the TIPQC Missed CCHD data collection group to improve the care of children in Tennessee, and Dr Peter Grubb and Brenda Barker the administrative leaders of the TIPQC for helping to improve the quality of care in Tennessee. We want to acknowledge Tennessee Commissioner of Health, Dr John Dreyzehner and the Tennessee Genetics advisory committee for looking to provide the most cost efficient care for the children of Tennessee. The first author’s fellowship training is supported by the T32HL 105334 Grant from the National Institutes of Health. Research reported in this article was supported by the National Center for Advancing Translational Sciences of the National Institute of Health under Award Number UL1 TR000445 and the Vanderbilt CTSA grant UL1 RR024975 from the National Center for Research Resources at the National Institutes of Health State of TN IRB 534289-2.
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Mouledoux, J., Guerra, S., Ballweg, J. et al. A novel, more efficient, staged approach for critical congenital heart disease screening. J Perinatol 37, 288–290 (2017). https://doi.org/10.1038/jp.2016.204
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DOI: https://doi.org/10.1038/jp.2016.204
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