Pulse Oximetry Value -Infant

Pulse Oximetry Value -Infant

Pulse Oximetry Value

Summary of Recommendation and Evidence

Population

Recommendation

Grade
(What's This?)

Screening of both Genders

This screening is recommended a best practice.

B

Pulse Oximetry:

  • Measures the oxygen saturation of the blood
  • Is non-invasive and painless
  • Is accurate and reliable
  • Is fast and easy to perform; and
  • Is inexpensive

 

Pulse Oximetry testing should always be used as a compliment to the physical examination and should never be used as a replacement.

WHO SHOULD BE SCREENED?

Newborns who are 24-48 hours of age. The closer to 48 hours, the better.

If an early discharge is planned, pulse oximetry screening should be performed as late as possible before hospital discharge.

Infants in neonatal intensive care units should be screened at 24-48 hours of age or when medically appropriate after 24 hours of age.

HOW CAN PULSE OXIMETRY TESTING HELP?

Detection of CCHD increases to about 85% before hospital discharge with the use of Pulse Oximetry as part of an infant’s routine newborn screen.

With the use of Pulse Oximetry, CCHD benefits from early detection and interventions such as:

  • Surgery
  • Heart Catheterization
  • Medication

WHY IS THIS SCREENING IMPORTANT?

CONGENITAL HEART DISEASE

  • The most common of all birth defects.
  • Affects 1 in every 100 babies in the U.S. each year.
  • Accounts for nearly 30% of all infant deaths due to birth defects.

Unfortunately, a seemingly normal, healthy infant can suddenly experience serious or life-threatening complications within the first few days or weeks of life that requires emergency care.

According to a recent California study, the median age of death due to undiagnosed CCHD is less than 2 weeks of age.

How is screening for CCHD done?

A small soft sensor is wrapped around the baby's right hand and one foot to measure the heart rate and oxygen level in the blood. It is fast, easy, and does not hurt.

The pulse oximetry screening occurs after 24 hours after birth to allow the baby's heart and lungs to fully adjust to life outside his or her mother. After the screening is completed, the doctor or nurse will go over the reading with the baby's parents. 

What happens a baby fails the pulse oximetry screening?

If the screening test suggests a problem, the doctor will speak directly with the parents and will order follow-up testing before a baby is discharged from the hospital. This may include an echocardiogram ("echo)—an ultrasound of the heart. The heart echo will screen for a serious problem in the structure of the heart or the blood flow through the heart and is read by a pediatric cardiologist. If the heart echo shows any problems, the baby's medical team will discuss next steps with the parents.

If a baby passes the pulse oximetry screening, does it mean he or she has no heart defects?

Pulse oximetry testing picks up only some types of heart defects. Some heart defects do not change blood oxygen levels and are not picked up by the test.

Even if a baby passes the pulse oximetry screening, parents should watch:

  • How well their baby is feeding
  • Any difficulty in breathing
  • Increased irritability
  • Excessive sleepiness
  • Bluish color to the lips or skin
  • Grunting
  • Fast breathing
  • Poor weight gain

Parents are advised to contact their baby's doctor right away if they notice any of these signs.

TIPS ON PROPER SCREENING

  • Conduct the screening in a quiet area.
  • Do not attempt to perform pulse oximetry on an infant while the baby is crying or if the baby is cold.
  • If possible, conduct screening while the infant is awake and calm.
  • Make sure the infant’s right hand and both feet are clean and dry. Substances, such as dried blood, can affect the pulse ox reading.

NATIONALLY RECOMMENDED

The addition of Pulse Oximetry Screening for Critical Congenital Heart Disease (CCHD) is endorsed by:

  • United States Health and Human Services (HHS) Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children (SACHDNC)
  • American Heart Association
  • American Academy of Pediatrics
  • American College of Cardiology
  • American College of Medical Genetics; and
  • March of Dimes