The Role of Newborn Pulse Oximetry Screening for Detecting Critical Congenital Heart Defects: A Narrative Review.

IF 1.3 Q3 PEDIATRICS Current Pediatric Reviews Pub Date : 2024-10-31 DOI:10.2174/0115733963315664241024043935
Giuseppe De Bernardo, Maria Rosaria Arienzo, Flavia Barbieri, Fabio Centanni, Francesconina Moccia, Maurizio Giordano, Giuseppe Buonocore, Serafina Perrone
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Abstract

Critical congenital heart diseases are life-threatening, with a high morbidity rate and mortality among newborns; in fact, a newborn discharged from the hospital with undiagnosed heart disease may experience severe complications during the initial days or weeks of their life, necessitating emergency care and even death. Among all kinds of critical congenital heart disease, coarctation of the aorta is one of the most difficult to diagnose because it only becomes noticeable a few days after birth, when patients have already been discharged from the hospital. This underlines the importance of having a reliable diagnostic tool to discover these diseases. The identification of some of these patients can be achieved through newborn screening with pulse oximetry, but only a small number are diagnosed. Hence, the objective of this review was to determine the value of pulse oximetry screening for the early detection of congenital heart defects in newborns, with a focus on coarctation of the aorta. A literature search was conducted between December 2023 and February 2024 using four electronic databases: Pubmed, Google Scholar, Embase, and Scopus to identify studies that evaluated the efficacy of pre- and post-discharge neonatal ductal saturation monitoring for the diagnosis of critical congenital heart defects before discharge. Twenty research studies with a large number of patients, demonstrating moderate sensitivity and high specificity of pulse oximetry test in detecting critical heart defects, especially coarctation of the aorta, were selected and analyzed. Many confirmations have been found of how good the specificity of screening is, reaching an average value of 99.9% in each study analyzed. The problem still lies in the sensitivity of the screening, which is not as good as the specificity, never reaching 90% in any of the studies analysed. So, it is crucial to keep up with efforts to improve the efficacy of the pulse oximetry screening method.

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新生儿脉搏氧饱和度筛查在检测严重先天性心脏缺陷中的作用:叙述性综述。
危重先天性心脏病危及生命,在新生儿中发病率和死亡率都很高;事实上,未确诊心脏病的新生儿在出院后的最初几天或几周内可能会出现严重的并发症,需要急救,甚至死亡。在各种危重的先天性心脏病中,主动脉闭塞症是最难诊断的疾病之一,因为它只有在出生后几天,患者已经出院时才会被发现。这就强调了拥有可靠的诊断工具来发现这些疾病的重要性。通过脉搏血氧仪进行新生儿筛查,可以发现其中一些患者,但只有少数患者被确诊。因此,本综述的目的是确定脉搏血氧仪筛查对早期发现新生儿先天性心脏缺陷的价值,重点是主动脉闭塞。我们在 2023 年 12 月至 2024 年 2 月期间使用四个电子数据库进行了文献检索:Pubmed、Google Scholar、Embase 和 Scopus,以确定评估出院前后新生儿导管饱和度监测对出院前诊断危重先天性心脏缺陷疗效的研究。研究选取并分析了 20 项研究,这些研究涉及大量患者,证明脉搏血氧饱和度检测在发现危重心脏缺陷(尤其是主动脉共动脉瘤)方面具有中等灵敏度和较高特异性。许多研究证实了筛查的特异性有多高,每项分析研究的平均值都达到了 99.9%。问题仍然在于筛查的灵敏度,它没有特异性那么好,在所分析的研究中从未达到 90%。因此,继续努力提高脉搏血氧仪筛查方法的有效性至关重要。
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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
66
期刊介绍: Current Pediatric Reviews publishes frontier reviews on all the latest advances in pediatric medicine. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in pediatric medicine.
期刊最新文献
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