Perfusion index cannot be currently recommended as an additional newborn screen for critical congenital heart disease: more data needed

Ewer, Andrew K

doi:10.1136/archdischild-2018-316515

Cited by 4 publications

(4 citation statements)

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“…The PPI can in fact be influenced, on the first day of life, from conditions such as low body temperature and eventual physiological acrocyanosis [ 16 ]. According to a recent study, PPI measurements combined with pulse oximetry and clinical data are useful for the early identification of obstructive lesions of the left heart; however, the literature data are not yet conclusive and, indeed, other authors state that the perfusion index cannot be currently recommended as an additional newborn screening for CCHD [ 28 , 30 , 31 ]. In our study, the PPI increased the predictive role of POS in detecting pathological conditions and the risk of false positives appeared to be reasonable if compared with the risk of missing diagnosis of life-threatening diseases.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Saturation and Perfusion Index on the First Day of Life Play a Role in Early Discharge of Healthy Term Newborns

Perrone

Giordano

Bernardo

et al. 2022

International Journal of Clinical Practice

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Introduction. Pulse oximetry screening is a safe, feasible test, effective in identifying congenital heart diseases in otherwise well-appearing newborns. Uncertainties still persist on the most effective algorithm to be used and the timing of screening. The aim of this study was to evaluate the role of the pulse oximetry screening associated with the peripheral perfusion index performed in the first 24 hours of life for the early detection of congenital heart diseases and noncongenital heart diseases in the newborns. Materials and Methods. A prospective observational cohort study was conducted. The enrollment criteria were as follows: term newborns with an APGAR score >8 at 5 minutes. The exclusion criteria were as follows: clinical signs of prenatal/perinatal asphyxia or known congenital malformations. Four parameters of pulse oximetry screening were utilized: saturation less than 90% (screening 1), saturation of less than 95% in one or both limbs (screening 2), difference of more than 3% between the limbs (screening 3), and preductal peripheral perfusion index or postductal peripheral perfusion index below 0.70 (screening 4). The likelihood ratio, sensibility, specificity, and positive and negative predictive values for identification of congenital heart diseases or noncongenital heart diseases (suspicion of perinatal infection and any respiratory diseases) were evaluated. Results. The best predictive results for minor congenital heart disease were obtained combining screening 3 and screening 4 (χ2 (1) = 15,279; p < 0.05 ; OR = 57,900 (9,465–354,180)). Screening 2, screening 3, and screening 4 were predictive for noncongenital heart diseases (χ2 (1) = 11,550; p < 0.05 ; OR = 65,744 (10,413–415,097)). Combined screenings 2–4 were predictive for both congenital heart disease and noncongenital heart disease (χ2 (1) = 22,155; p < 0.05 ; OR = 117,685 (12,972–1067,648)). Conclusions. Combining peripheral saturation with the peripheral perfusion index in the first 24 hours of life shows a predictive role in the detection of minor congenital heart diseases and neonatal clinical conditions whose care needs attention.

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Section: Discussionmentioning

confidence: 99%

Peripheral Saturation and Perfusion Index on the First Day of Life Play a Role in Early Discharge of Healthy Term Newborns

Perrone

Giordano

Bernardo

et al. 2022

International Journal of Clinical Practice

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“…Su uso rutinario como parámetro adicional de tamizaje aún se discute, pues aunque podría incrementar la sensibilidad, potencialmente también incrementaría la cantidad de casos falsos positivo incrementar la sensibilidad, incluso la cantidad de casos falsos positivos. 10…”

Section: íNdice De Perfusiónunclassified

Tamiz Neonatal Cardiaco

Mier Martínez,

García Benitez,

Tamariz Cruz

2023

Acta Pediatr Mex

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El TNC es una estrategia que nos permitirá incrementar el número de pacientes con CCC que se detectan oportunamente. Si bien, aún está pendiente la publicación de la Norma Oficial Mexicana en donde se establezca el marco normativo y operativo para su implementación, así como el algoritmo a emplearse en el territorio nacional, es importante que el médico pediatra y de primer contacto se encuentre familiarizado con el concepto de TNC, los algoritmos, así como la interpretación de sus resultados.

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“…15,16,18 However, existing data do not yet support inclusion of PI to neonatal CCHD-screening, the high false-positive rate is one concern. 20,21 We hypothesised that the false-positive rate of PI can be reduced by repeating the measurement if below cut-off. Thus, our primary aim was to prospectively determine the false-positive rate of PI in the newborn in a screening setting, using previously proposed cut-offs and three consecutive measurements if below cut-off.…”

Section: Introductionmentioning

confidence: 99%

“…PI as a screening tool has raised some hope in increasing neonatal detection of CoA and other LHOD, 14–19 with reported sensitivities for CoA varying between 33% and 100% depending on the cut‐offs used 15,16,18 . However, existing data do not yet support inclusion of PI to neonatal CCHD‐screening, the high false‐positive rate is one concern 20,21 …”

Section: Introductionmentioning

confidence: 99%

Low false‐positive rate of perfusion index as a screening tool for neonatal aortic coarctation

2020

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Perfusion index cannot be currently recommended as an additional newborn screen for critical congenital heart disease: more data needed

Cited by 4 publications

References 5 publications

Peripheral Saturation and Perfusion Index on the First Day of Life Play a Role in Early Discharge of Healthy Term Newborns

Peripheral Saturation and Perfusion Index on the First Day of Life Play a Role in Early Discharge of Healthy Term Newborns

Tamiz Neonatal Cardiaco

Low false‐positive rate of perfusion index as a screening tool for neonatal aortic coarctation

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