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TUESDAY, Aug. 23 (HealthDay News) -- U.S. Food and Drug Administration (FDA) approved motion-tolerant pulse oximeters should be used to screen critical congenital heart disease (CCHD) in newborns, according to the recommendations in a report endorsed by the American Academy of Pediatrics, the American College of Cardiology Foundation, and the American Heart Association, and published online Aug. 22 in Pediatrics in preprint format.
Alex R. Kemper, M.D., M.P.H., from Duke University in Durham, N.C., and colleagues sought to develop strategies for the implementation of safe, effective, and efficient screening and diagnostic follow-up for CCHD among newborns. Their recommendations were based on published and unpublished data.
The investigators recommended that protocols for arranging diagnostic follow-up should be established before implementing screening. FDA approved motion-tolerant pulse oximeters that report functional oxygen saturation should be used for CCHD screening. Qualified personnel (trained to use the recommended screening algorithm and monitor pulse oximetry) should conduct the screening based on the algorithm, and adjust the algorithm cut-offs in high-altitude nurseries, as necessary. Complete clinical evaluation by a licensed, independent practitioner should be done for every abnormal pattern of low blood oxygen saturation. Hospitals and birthing centers should develop strategies for quality assurance, and monitor the impact of screening in partnerships with local and state public health agencies. Primary care providers should assure appropriate screening for newborns in their practice and ensure long-term follow-up for those diagnosed with CCHD. Electronic pulse oximetry monitoring and diagnostic outcomes should be reported according to established standards. Research should focus on screening in special populations and in nurseries without onsite echocardiography.
"The workgroup members found sufficient evidence to begin screening for low blood oxygen saturation through the use of pulse oximtery monitoring to detect CCHD in well-baby and intermediate-care nurseries," the authors write.
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