January 4, 2012 -- NEW YORK (Reuters Health) - Newborns should undergo pulse oximetry to screen for critical congenital heart disease (CCHD), according to a new policy statement from the American Academy of Pediatrics (AAP).
The statement, in the January issue of Pediatrics, is an endorsement of Health and Human Services Secretary Kathleen Sebelius' September 2011 recommendation that CCHD be part of the recommended uniform screening panel.
Currently, according to the AAP, clinicians rely on prenatal ultrasound and physical examination of newborns to identify CCHD. "Unfortunately, this approach fails to identify a significant number of cases of CCHD, which may lead to late diagnosis with significant morbidity, permanent injury of vital organs, and in some cases, death," members of the Section on Cardiology and Cardiac Surgery Executive Committee write in the new report.
The committee offers "highlights" of the AAP's full recommendation for implementing screening, published in an earlier issue of its journal. These points include performing screening in the newborn nursery, using motion-tolerant pulse oximeters, and delaying screening until a child is at least 24 hours old in order to reduce false-positive results.
According to the statement, readings should be obtained in the right hand and one foot. A reading of 95% or higher in at least one extremity with an absolute difference of 3% or less between the upper and lower extremity is considered negative. Positive measurements should be repeated, the committee says, while a child with oxygen saturation below 90% requires immediate evaluation.
Finally, a diagnostic echocardiogram should be used to exclude CCHD, and clinicians should also exclude an infectious or pulmonary cause of hypoxemia, according to the statement.
"It is imperative that AAP members engage their respective policy makers in adopting and funding the recommendations made by the Secretary of HHS," the AAP concludes.
Pediatrics 2012; 129:190-192.
Last Updated: 2012-01-03 18:15:25 -0400 (Reuters Health)
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