Critical Congenital Heart Disease Screening in NICU: Need for Revision and Standardization

Nithi Fernandes, Billie Short, Veena Manja, Satyanarayana Lakshminrusimha

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Screening for critical congenital heart disease (CCHD) at 24 to 48 hours after birth or before discharge in newborn nurseries using pulse oximetry is effective and is mandated by most states. However, there is no established protocol for screening in a neonatal intensive care unit (NICU), a setting where neonates are continuously monitored by pulse oximetry, hypoxemia from noncardiac causes is common, and echocardiograms are frequently obtained. CCHDs with hypoxemia are suspected on admission and investigated with an echocardiogram before a formal screen in the NICU. The most common CCHD lesions missed in a NICU setting are secondary targets of the screen, such as aortic arch anomalies (coarctation or interrupted aortic arch). The sensitivity of the current pulse oximeter-based CCHD screen to diagnose aortic arch anomalies is low. Given that infants are monitored with continuous pulse oximetry and frequent examinations, novel revisions to the current screening methods are necessary to detect asymptomatic NICU infants with aortic arch anomalies before discharge. Exclusions (whom to screen), technique (how to screen), and timing (when to screen) for primary and secondary targets of CCHD in the NICU are not known and require further research.

Original languageEnglish (US)
Pages (from-to)1470-1476
Number of pages7
JournalAmerican Journal of Perinatology
Volume34
Issue number14
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Neonatal Intensive Care Units
Heart Diseases
Thoracic Aorta
Oximetry
Newborn Infant
Nurseries
Pulse
Parturition
Research
Hypoxia

Keywords

  • critical congenital heart disease
  • hypoxemia
  • pulse oximeter
  • sensitivity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Critical Congenital Heart Disease Screening in NICU : Need for Revision and Standardization. / Fernandes, Nithi; Short, Billie; Manja, Veena; Lakshminrusimha, Satyanarayana.

In: American Journal of Perinatology, Vol. 34, No. 14, 01.12.2017, p. 1470-1476.

Research output: Contribution to journalReview article

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