Früherfassung von zyanotischen Herzfehlern mit der Pulsoximetrie

Background: Approximately half of all newborns with congenital heart disease are asymptomatic in the first days of life. Early detection of ductal-dependant cardiac malformations prior to ductal closure is, however, of significant clinical importance as treatment outcome is related to the time of diagnosis. To date, relatively few studies have reported the use of pulse oximetry for early detection of congenital heart disease.

Aims: 1) to determine the effectiveness of pulse oximetry for the detection of congenital heart disease in otherwise healthy newborns, 2) to determine if routine pulse oximetry has improved early detection of congenital heart disease in newborns, and 3) to evaluate the ease of use of routine pulse oximetry as a screening method.

Methods: This is a prospective, multicentre study. Postductal pulse oximetry, between 6 and 12 hours of age, was performed in all newborns from 35 0/7 weeks gestation. If pulse oximetry measured oxygen saturation was less than 95% an echocardiogram was performed. The results were compared with a retrospective analysis of all infants with congenital heart disease born during the previous year.

Results: Pulse oximetry was performed in 3292 newborns. 24 infants (0.7%) had saturations <95%. Of these infants 17 had congenital heart disease and 5 of the remaining 7 had persistant pulmonary hypertension (5). No infant with a cyanotic congenital heart disease exhibited saturation values ³ 95%.

Conclusion: Routine postductal pulse oximetry in the first day of life is an effective means of detecting congenital heart disease in otherwise healthy newborns.