CCHD Screening Implementation Efforts in Latin American Countries by the Ibero American Society of Neonatology (SIBEN)

Sola, Augusto; Rodríguez, Susana; Young, Alejandro; Varela, Lourdes Lemus; Villamayor, Ramón Mir; Cardetti, Marcelo; Navarrete, Jorge Alberto Pleitez; Favareto, María Verónica; Lima, Victoria; Baquero, Hernando; Forero, Lorena Velandia; Venegas, Maria Elena; Dávila, Carmen Salvat; Dieppa, Fernando Domínguez; Germosen, Taina Malena; Barrantes, Ada Nidia Oviedo; Castañeda, Ana Lorena Alvarez; Morgues, Mónica; Avila, Aldana; Fariña, Diana; Oliva, José Luís; Sosa, Erika; Golombek, Sergio

doi:10.3390/ijns6010021

Cited by 13 publications

(8 citation statements)

References 29 publications

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“…Globally, many research studies have been performed on pulse oximetry screening for detection of critical CHDs [ 5 , 13 ]–[ 15 , 19 , 20 , 25 , 28 ]. Most have focused on the detection of CCHDs and non-cardiac conditions by POS: there remains a paucity of data on missed cases of CCHD and major CHDs not detected by pulse oximetry screening.…”

Section: Discussionmentioning

confidence: 99%

“…It can furthermore detect significant hypoxemic non-cardiac conditions, such as sepsis or respiratory conditions [20]. Future utility of pulse oximetry could also be augmented with addition of peripheral perfusion index measurements that may have added value in detection of left-sided obstructive CHDs that may be missed by POS alone [21]- [24] As a result, routine pulse oximetry screening in neonates has been implemented in many countries globally [5,25], as well as in around 50% hospitals in the UK despite no recommendation from the UK National Screening Committee (UKNSC) [18,26,27]. Many POS studies have been published; however, studies on postnatal detection and presentation of all CHDs, the impact on clinical practice and what cardiac conditions lead to a false negative POS test result are still lacking.…”

Section: Introductionmentioning

confidence: 99%

“…As a result, routine pulse oximetry screening in neonates has been implemented in many countries globally[ 5 , 25 ], as well as in around 50% hospitals in the UK despite no recommendation from the UK National Screening Committee (UKNSC)[ 18 , 26 , 27 ]. Many POS studies have been published; however, studies on postnatal detection and presentation of all CHDs, the impact on clinical practice and what cardiac conditions lead to a false negative POS test result are still lacking.…”

Section: Introductionmentioning

confidence: 99%

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Impact of pulse oximetry screening to detect congenital heart defects: 5 years’ experience in a UK regional neonatal unit

Singh

Chen

2021

Eur J Pediatr

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Pulse oximetry screening (POS) has been shown to be an effective, non-invasive investigation that can detect up to 50–70% of previously undiagnosed congenital heart defects (CHDs). The aims of this study were to assess the accuracy of POS in detection of CHDs and its impact on clinical practice. All eligible newborn infants born between 1 Jan 2015 and 31 Dec 2019 in a busy regional neonatal unit were included in this prospective observational study. A positive POS was classified as two separate measurements of oxygen saturation < 95%, or a difference of > 2% between pre- and post-ductal circulations. Overall, 23,614 infants had documented POS results. One hundred eighty nine (0.8%) infants had a true positive result: 6 had critical CHDs, 9 serious or significant CHDs, and a further 156/189 (83%) infants had significant non-cardiac conditions. Forty-three infants who had a normal POS were later diagnosed with the following categories of CHDs post-hospital discharge: 1 critical, 15 serious, 20 significant and 7 non-significant CHDs. POS sensitivity for detection of critical CHD was 85.7%, whereas sensitivity was only 33% for detection of major CHDs (critical and serious) needing surgery during infancy; specificity was 99.3%.Conclusion: Pulse oximetry screening showed moderate to high sensitivity in detection of undiagnosed critical CHDs; however, it failed to detect two-third of major CHDs. Our study further emphasises the significance of adopting routine POS to detect critical CHDs in the clinical practice. However, it also highlights the need to develop new, innovative methods, such as perfusion index, to detect other major CHDs missed by current screening tools. What is Known:• Pulse oximetry screening is cost effective, acceptable, easy to perform and has moderate sensitivity and high specificity in detection of critical congenital heart defects.• Pulse oximetry screening has been implemented many countries including USA for detection of critical congenital heart defects, but it is not currently recommended by the UK National Screening Committee. What is New:• To our knowledge, this is the first study describing postnatal detection and presentation of all the infants with congenital heart defects over a period of 5 years, including those not detected on the pulse oximetry screening, on the clinical practice. • It emphasises that further research required to detect critical congenital heart defects and other major CHDs which can be missed on the screening tools currently employed in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of pulse oximetry screening to detect congenital heart defects: 5 years’ experience in a UK regional neonatal unit

Singh

Chen

2021

Eur J Pediatr

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“…This is relevant since remarkable limitations are commonly found in similar studies due to our socio-demographic context. 25…”

Section: Discussionmentioning

confidence: 99%

Critical CHD screening programme: a 3-year multicentre experience in Mexico

et al. 2022

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Introduction: CHDs are the most common type of birth defect. One in four newborns with a heart defect has a critical CHD. In Mexico, there is a lack of data available to determine its prevalence. Pulse oximetry screening programmes have been implemented worldwide, reporting opportunity areas in algorithm interpretation and data management. Our study aims to share preliminary results of a 3-year experience of a multicentre pulse oximetry screening programme that addresses critical challenges. Materials and methods: This retrospective study examined the reports of newborns screened from February 2016 to July 2019 from five hospitals. Two algorithms –the New Jersey and the American Academy of Pediatrics– were implemented over consecutive periods. The algorithms’ impact was assessed through the calculation of the false-positive rate in an eligible population. Results: A total of 8960 newborns were eligible for the study; from it, 32.27% were screened under the New Jersey and 67.72% under the American Academy of Pediatrics algorithm – false-positive rate: 1% (CI 95: ± 0.36%) and 0.71% (CI 95: ± 0.21%), respectively. Seventy-nine newborns were referred, six were diagnosed with critical CHD, and six with CHD. The critical CHD estimated prevalence was 6.69:10,000 newborns (CI 95: ± 5.36). Our results showed that the algorithm was not related to the observable false-positive rate reduction. Discussion: Other factors may play a role in decreasing the false-positive rate. Our experience implementing this programme was that a systematic screening process led to more confident results, newborn’s report interpretation, and follow-up.

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“…16 Por otro lado, existen evidencias del uso de la POP en diferentes países de la región de América Latina, pero de forma limitada. 17 La efectividad de la POP ha sido estudiada ampliamente. Varios estudios han reportado una sensibilidad relativamente baja (76%), con una variación importante en los casos falsos positivos (0.14-1.8%).…”

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Análisis de costoefectividad de la oximetría de pulso como prueba de detección de las cardiopatías congénitas críticas en México

et al. 2022

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Objetivo. Realizar un análisis de costoefectividad de la oximetría de pulso como prueba de detección neonatal de las cardiopatías congénitas críticas (CCC) en México. Material y métodos. Se realizó un estudio de evaluación económica desde la perspectiva de los proveedores de servicios de salud. A través de un árbol de decisiones se comparó la examinación física versus la examinación física junto con la prueba de oximetría de pulso (POP). Resultados. Por cada 10 000 recién nacidos, la alternativa con la POP detectó 32 casos adicionales de CCC, con una razón de costoefectividad incremental de 1 219 USD y una probabilidad de costoefectividad mayor a 90% con una disposición a pagar de 25 000 USD por cada detección temprana. Conclusión. La costoefectividad de la POP, como tamiz neonatal cardiaco, es mayor en México que en países de altos ingresos, y representa una inversión costoefectiva para ganar años de vida en la población infantil de México.

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CCHD Screening Implementation Efforts in Latin American Countries by the Ibero American Society of Neonatology (SIBEN)

Cited by 13 publications

References 29 publications

Impact of pulse oximetry screening to detect congenital heart defects: 5 years’ experience in a UK regional neonatal unit

Impact of pulse oximetry screening to detect congenital heart defects: 5 years’ experience in a UK regional neonatal unit

Critical CHD screening programme: a 3-year multicentre experience in Mexico

Análisis de costoefectividad de la oximetría de pulso como prueba de detección de las cardiopatías congénitas críticas en México

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