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Oxygen saturation and perfusion index screening in neonates at high altitudes: can PDA be predicted?

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Abstract

Screening critical congenital heart disease in neonates with 24–48 h of age could be made by oxygen saturation determination. Perfusion index may be used as an adjunct to pulse oximetry screening to detect non-cyanotic critical congenital heart disease cases such as a left heart outflow obstruction. We evaluate the results of combined screening for oxygen saturation and peripheral perfusion index at high altitudes. The study included 501 neonates older than gestational week 35. The mean oxygen saturation was lower than at sea level, and the screening test was positive in a total of 21 (4.2%) babies. Critical congenital heart diseases were not detected in any patient. A total of 10 (2%) babies were detected with PDA, nine (1.8%) of whom recorded a positive screening test. The prevalence of PDA was significantly higher in the positive screening test group when compared with those who underwent echocardiography due to clinical findings.

Conclusion: The median peripheral perfusion index at high altitude was not lower than at sea level, while the mean oxygen saturation, in contrast, was lower than at sea level. The low partial oxygen pressure found at high altitudes leads to a variation in postnatal adaptation and an increased prevalence of PDA. Accordingly, oxygen saturation screening may serve to identify babies with PDA at high altitudes.

What is Known:

• Oxygen saturation is known to be low at high altitudes, and thus the rates of false positivity are high when screening for critical congenital heart disease.

• High altitudes are also associated with an increased prevalence of simple congenital heart disease.

What is New:

• The peripheral perfusion index at high altitude is not lower than at sea level.

• The prevalence of PDA is significantly higher in those with false positive screening results.

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Abbreviations

ASD:

Atrial septal defect

CCHD:

Critical congenital heart disease

CHD:

Congenital heart disease

PDA:

Patent ductus arteriosus

PPI:

Peripheral perfusion index

VSD:

Ventricular septal defect

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Ataturk University Medical Faculty, Erzurum, Turkey

    Kadir Şerafettin Tekgündüz & Mustafa Kara

  2. Department of Pediatrics, Ataturk University Medical Faculty, Erzurum, Turkey

    Merve Bilen

  3. Department of Pediatrics, Division of Pediatric Cardiology, Ataturk University Medical Faculty, Erzurum, Turkey

    Fuat Laloğlu & Naci Ceviz

Authors
  1. Kadir Şerafettin Tekgündüz
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  2. Merve Bilen
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  3. Mustafa Kara
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  4. Fuat Laloğlu
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  5. Naci Ceviz
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Kadir Şerafettin Tekgündüz, Merve Bilen, Mustafa Kara, Fuat Laloğlu and Naci Ceviz. The first draft of the manuscript was written by Kadir Şerafettin Tekgündüz and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript

Corresponding author

Correspondence to Kadir Şerafettin Tekgündüz.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of Ataturk University with decision no: 32/2018. Informed consent was obtained from the parent/s or legal guardian/s of the patients.

Additional information

Communicated by Daniele De Luca

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Tekgündüz, K.Ş., Bilen, M., Kara, M. et al. Oxygen saturation and perfusion index screening in neonates at high altitudes: can PDA be predicted?. Eur J Pediatr 180, 31–38 (2021). https://doi.org/10.1007/s00431-020-03698-1

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  • DOI: https://doi.org/10.1007/s00431-020-03698-1

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