The importance of screening for critical and severe congenital cardiac diseases by pulse oximetry in the early neonatal age – Position statement of the Hellenic Society of Perinatal Medicine (HSPM)

A. Petropoulos, George Daskalakis, F. Anatolitou, M. Eleftheriadis, P. Antsaklis, Athina Moutafi, P. Petropoulos, A. Varvarigou, Antonia Charitou
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Abstract

Background: From its first reported use in 2002, the efficiency of pulse oximetry (POX) screening in detecting critical and severe congenital heart disease (c/s-CHD) in term neonates in early days after delivery has been proved by numerous studies. It is low-cost, non-invasive, easy to use, repeatable, time-saving, applicable by even less-skilled nursing staff, proven to have excellent sensitivity and high specificity. When used in addition to the initial physician’s examination before dismissing a newborn home, this postnatal test can increase the clinical accuracy of detecting c/s-CHD. In this sense, it must be used as an early detecting screening test. Its use is more important during the period in which the patent ductus arteriosus (PDA) conceals the signs and symptoms of low cardiac output syndrome (LCOs) or severe cyanosis that will lead to notably hypoxia and acidosis. These free-of-symptoms babies that leave maternity units although critically ill, as well as those that are born at home and assessed by primary care, will benefit the most through a compulsory use of this test. Despite the benefits, it has failed to become a universal screening test for early detection of c/s-CHD, especially in Europe. Aim: To discuss the existing evidence on safe, effective, and efficient screening, using POX in combination with initial pre-discharge physical examination at the end of its stay under maternity services, including births out of medical facilities, for every term baby as a compulsory health screening test in Greece. Methods: The authors, members of the Hellenic Society of Perinatal Medicine (HSPM), reviewed the existing up-to-date literature and the trend of using this test worldwide and especially in European countries. They also consulted with pioneers and experts in the field. Results: Based on published data, the authors clarify existing policies of using POX and initial clinical assessment, aiming to a standardized approach of screening and diagnostic follow-up, when needed. Key issues for future research and evaluation were identified and addressed. Conclusions: The authors clarify existing policies in the use of POX, aiming to suggest the most appropriate way of using the test for compulsory screening term newborns during the early neonatal period in Greece. Special conditions of screening are being discussed. Public health organizations and private health agencies will have an important role in quality assurance and surveillance of this screening test aiming to significantly reduce morbidity and mortality from c/s-CHD in Greece.
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新生儿早期脉搏血氧仪筛查危重先天性心脏病的重要性——希腊围产期医学会(HSPM)立场声明
背景:自2002年首次报道以来,脉搏血氧仪(POX)筛查在分娩后早期检测足月新生儿危重和重度先天性心脏病(c/s-CHD)的有效性已被大量研究证明。它成本低,无创,易于使用,可重复,节省时间,即使是不熟练的护理人员也适用,具有优异的灵敏度和高特异性。当在新生儿出院前进行初步医生检查时,这种产后检查可以提高检测c/s-CHD的临床准确性。从这个意义上说,它必须作为一种早期检测筛选试验。当动脉导管未闭(PDA)掩盖了低心输出量综合征(LCOs)或严重紫绀的体征和症状时,其使用更为重要,这将导致明显的缺氧和酸中毒。这些虽然病重但离开产科病房却无症状的婴儿,以及那些在家中出生并经初级保健评估的婴儿,将通过强制使用这种检测受益最大。尽管有这些好处,但它未能成为早期发现c/s-CHD的普遍筛查试验,特别是在欧洲。目的:讨论关于安全、有效和高效筛查的现有证据,在希腊,将POX与产科服务结束时的初始出院前体检相结合,包括在医疗机构外分娩,作为每个足月婴儿的强制性健康筛查测试。方法:作者是希腊围产期医学协会(HSPM)的成员,回顾了现有的最新文献和在世界范围内特别是在欧洲国家使用该测试的趋势。他们还咨询了该领域的先驱和专家。结果:基于已发表的数据,作者阐明了痘的现有使用政策和初步临床评估,旨在必要时制定标准化的筛查和诊断随访方法。确定并解决了未来研究和评价的关键问题。结论:作者澄清了现行的使用POX的政策,旨在建议在希腊新生儿早期使用该测试强制筛查足月新生儿的最合适方法。正在讨论筛选的特殊条件。公共卫生组织和私营卫生机构将在质量保证和监测这一筛查试验方面发挥重要作用,旨在显著降低希腊c/s-CHD的发病率和死亡率。
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来源期刊
CiteScore
1.00
自引率
25.00%
发文量
0
审稿时长
12 weeks
期刊介绍: The Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) is a peer-reviewed interdisciplinary journal which provides a forum on new perspectives in pediatric and neonatal medicine. The aim is to discuss and to bring readers up to date on the latest in research and clinical pediatrics and neonatology. Special emphasis is on developmental origin of health and disease or perinatal programming and on the so-called ‘-omic’ sciences. Systems medicine blazes a revolutionary trail from reductionist to holistic medicine, from descriptive medicine to predictive medicine, from an epidemiological perspective to a personalized approach. The journal will be relevance to clinicians and researchers concerned with personalized care for the newborn and child. Also medical humanities will be considered in a tailored way. Article submission (original research, review papers, invited editorials and clinical cases) will be considered in the following fields: fetal medicine, perinatology, neonatology, pediatrics, developmental programming, psychology and medical humanities.
期刊最新文献
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