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Pulsoxymetriescreening bei Neugeborenen auf kritische angeborene Herzfehler

Empfehlungen der Arbeitsgruppen Pädiatrische Kardiologie und Neonatologie/Pädiatrische Intensivmedizin der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde

Pulse oximetry screening of neonates for critical congenital heart disease

Recommendations of the working group on pediatric cardiology and neonatology/pediatric intensive care medicine of the Austrian Society for Pediatrics and Adolescent Medicine

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Zusammenfassung

Angeborene Herzfehler treten mit einer Prävalenz von ca. 7–12/1000 Lebendgeborene auf und sind für bis zu 20 % der Todesfälle im Neugeborenenalter verantwortlich. Konventionelle Screeningverfahren wie Pränataldiagnostik und postnatale klinische Untersuchung(en) detektieren kritische angeborene Herzfehler immer noch mit einer unzureichenden Sensitivität bzw. Spezifität. Der internationale Trend zur frühzeitigen Entlassung der Neugeborenen erhöht das Risiko, kritische angeborene Herzfehler während der postpartalen Hospitalisierung nicht zu diagnostizieren, woraus sich die Notwendigkeit neuer Strategien zur Früherkennung dieser Erkrankungen ergibt. Das Pulsoxymetriescreening (POS) konnte als einfaches, schmerzfreies, leicht verfügbares, kostengünstiges, hochspezifisches und ausreichend sensitives, ergänzendes Verfahren bestätigt werden, um kritische angeborene Herzfehler noch im präsymptomatischen Zeitfenster zu erkennen. Der vorliegende Beitrag beschreibt die Empfehlungen der Arbeitsgruppen Pädiatrische Kardiologie und Neonatologie/Pädiatrische Intensivmedizin der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde zur Durchführung des POS.

Abstract

Congenital heart defects occur with a prevalence of approximately 7-12 per 1000 live births and are responsible for up to 20 % of fatalities of newborn infants. Conventional screening procedures, such as prenatal diagnostics and postnatal clinical examinations can still only detect critical congenital heart disease with insufficient sensitivity and specificity. The international trend to early hospital discharge of newborn infants increases the risk of not diagnosing critical congenital heart disease during the postpartum hospitalization period, which results in the necessity for new strategies for early recognition of these diseases. Pulse oximetry screening (POS) could be confirmed as a simple, painless, easily available, economic, highly specific and sufficiently sensitive supplementary procedure for the recognition of critical congenital heart disease. This article describes the recommendations of the working group for pediatric cardiology and neonatology/pediatric intensive care medicine of the Austrian Society for Pediatrics and Adolescent Medicine on carrying out POS.

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Literatur

  1. Mitchell SC, Korones SB, Berendes HW (1971) Congenital heart disease in 56,109 births. Incidence and natural history. Circulation 43:323–332

    Article  CAS  PubMed  Google Scholar 

  2. Hoffman JI, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol 39:1890–1900

    Article  PubMed  Google Scholar 

  3. Dolk H, Loane M, Garne E (2011) Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Circulation 123:841–849

    Article  PubMed  Google Scholar 

  4. Acharya G, Sitras V, Maltau JM et al (2004) Major congenital heart disease in Northern Norway: shortcomings of pre- and postnatal diagnosis. Acta Obstet Gynecol Scand 83:1124–1129

    Article  PubMed  Google Scholar 

  5. Lloyd-Jones D, Adams R, Carnethon M et al (2009) Heart disease and stroke statistics – 2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 119:480–486

    Article  PubMed  Google Scholar 

  6. Oster ME, Lee KA, Honein MA et al (2013) Temporal trends in survival among infants with critical congenital heart defects. Pediatrics 131:e1502–e1508

    Article  PubMed  Google Scholar 

  7. Frank LH, Bradshaw E, Beekman R et al (2013) Critical congenital heart disease screening using pulse oximetry. J Pediatrics 162:445–453

    Article  Google Scholar 

  8. Ewer AK, Middleton LJ, Furmston AT et al (2011) Pulse oximetry screening for congenital heart defects in newborn infants (Pulseox): a test accuracy study. Lancet 378:785–794

    Article  PubMed  Google Scholar 

  9. Wren C, Reinhardt Z, Khawaja K (2008) Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations. Arch Dis Child Fetal Neonatal Ed 93:F33–F35

    Article  CAS  PubMed  Google Scholar 

  10. Khoshnood B, De Vigan C, Vodovar V et al (2005) Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in France, 1983–2000: a population-based evaluation. Pediatrics 115:95–101

    PubMed  Google Scholar 

  11. de-Wahl Granelli A, Wennergren M, Sandberg K et al (2009) Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns. BMJ 338:a3037

    Article  Google Scholar 

  12. Mellander M, Sunnegårdh J (2006) Failure to diagnose critical heart malformations in newborns before discharge – an increasing problem? Acta Paediatr 95:407–413

    Article  PubMed  Google Scholar 

  13. Riede FT, Worner C, Dahnert I et al (2010) Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine – results from a prospective multicenter study. Eur J Pediatr 169:975–981

    Article  PubMed Central  PubMed  Google Scholar 

  14. Hoffman JI (2011) It is time for routine neonatal screening by pulse oximetry. Neonatology 99:1–9

    Article  PubMed  Google Scholar 

  15. Mahle WT, Newburger JW, Matherne GP et al (2009) Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the AHA and AAP. Pediatrics 124:823–836

    Article  PubMed  Google Scholar 

  16. Brown KL, Ridout DA, Hoskote A et al (2006) Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart 92:1298–1302

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Meberg A, Brügmann-Pieper S, Due R et al (2008) First day of life pulse oximetry screening to detect congenital heart defects. J Pediatr 152:761–765

    Article  PubMed  Google Scholar 

  18. Fouzas S, Priftis KN, Anthracopoulos MB (2011) Pulse oximetry in pediatric practice. Pediatrics 128:740–752

    Article  PubMed  Google Scholar 

  19. Aoyagi T (2003) Pulse oximetry: its invention, theory, and future. J Anesth 17:259–266

    Article  PubMed  Google Scholar 

  20. Goldman JM, Petterson MT, Kopotic RJ, Barker SJ (2000) Masimo signal extraction pulse oximetry. J Clin Monit Comput 16:475–483

    Article  CAS  PubMed  Google Scholar 

  21. Lundsgaard C, Van Slyke D, Abbott ME (1923) Cyanosis. Can Med Assoc J 13:601–604

    CAS  PubMed Central  PubMed  Google Scholar 

  22. Valmari P (2007) Should pulse oximetry be used to screen for congenital heart disease? Arch Dis Child Fetal Neonatal Ed 92:F219–F24

    Article  PubMed Central  PubMed  Google Scholar 

  23. Thangaratinam S, Brown K, Zamora J et al (2012) Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet 379:2459–2464

    Article  PubMed  Google Scholar 

  24. Prudhoe S, Abu-Harb M, Richmond S, Wren C (2013) Neonatal screening for critical cardiovascular anomalies using pulse oximetry. Arch Dis Child Fetal Neonatal Ed 98:F346–F350

    Article  PubMed  Google Scholar 

  25. Wilson J, Jungner G (1968) Principles and practice of screening for disease. Public Health Papers 34. WHO, Geneva

  26. Ewer AK, De-Wahl Granelli A, Manzoni P et al (2013) Pulse oximetry screening for congenital heart defects. Lancet 382:856–857

    Article  PubMed  Google Scholar 

  27. Kochilas LK, Lohr JL, Bruhn E et al (2013) Implementation of critical congenital heart disease screening in Minnesota. Pediatrics 132:e587–e594

    Article  PubMed  Google Scholar 

  28. Ewer AK, Furmston AT, Middleton LJ et al (2012) Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess 16:v–xiii, 1–184

    CAS  PubMed  Google Scholar 

  29. Peterson C, Grosse SD, Oster ME et al (2013) Cost-effectiveness of routine screening for critical congenital heart disease in US newborns. Pediatrics 132:e595–e603

    Article  PubMed  Google Scholar 

  30. Martin GR, Beekman RH, Mikula EB et al (2013) Implementing recommended screening for critical congenital heart disease. Pediatrics 132:e185–e192

    Article  PubMed  Google Scholar 

  31. Clark CA, Simeone SA, Gilboa SA et al (2013) Assessment of current practices and feasibility of routine screening for critical congenital heart defects – Georgia, 2012. MMWR Morb Mortal Wkly Rep 62:15

    Google Scholar 

  32. Fritz M, Gitter R, Nagel B et al (o J) Transthorakale Echokardiographie bei Kindern und Jugendlichen. Empfehlungen und Qualitätsstandards in Österreich. http://www.khbg.at

  33. Kemper AR, Mahle WT, Martin GR et al (2011) Strategies for implementing screening for critical congenital heart disease. Pediatrics 128:e1259–e1267

    Article  PubMed  Google Scholar 

  34. Ewer AK (2013) Pulse oximetry screening for critical congenital heart defects in newborn infants: should it be routine? Arch Dis Child Fetal Neonatal Ed 99:F93–F95

    PubMed  Google Scholar 

  35. Mahle WT, Martin GR, Beekman RH et al (2012) Endorsement of health and human services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics 129:190–192

    Article  PubMed  Google Scholar 

  36. Levesque BM, Pollack P, Griffin BE, Nielsen HC et al (2000) Pulse oximetry: what’s normal in the newborn nursery? Pediatr Pulmonol 30:406–412

    Article  CAS  PubMed  Google Scholar 

  37. Salyer JW (2003) Neonatal and pediatric pulse oximetry. Respir Care 48:386–396

    PubMed  Google Scholar 

  38. Gerstmann D, Berg R, Haskell R et al (2003) Operational evaluation of pulse oximetry in NICU patients with arterial access. J Perinatol 23:378–383

    Article  PubMed  Google Scholar 

  39. Jegatheesan P, Song D, Angell C et al (2013) Oxygen saturation nomogram in newborns screened for critical congenital heart disease. Pediatrics 131:e1803–e1810

    Article  PubMed  Google Scholar 

  40. Reich JD, Connolly B, Bradley G et al (2008) The reliability of a single pulse oximetry reading as a screening test for congenital heart disease in otherwise asymptomatic newborn infants. Pediatr Cardiol 29:885–889

    Article  CAS  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Fritz, P. Fritsch, M. Foramitti und B. Simma geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung Kinder- und Jugendheilkunde, Kinderkardiologie, Landeskrankenhaus Feldkirch - Akademisches Lehrkrankenhaus, Carinagasse 47, 6800, Feldkirch, Österreich

    M. Fritz & B. Simma

  2. Abteilung Pädiatrische Kardiologie, Univ. Klinik für Kinder- und Jugendheilkunde Graz, Graz, Österreich

    P. Fritsch

  3. Abteilung Kinder- und Jugendheilkunde, Landesklinikum Wiener Neustadt, Wiener Neustadt, Österreich

    M. Foramitti

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  1. M. Fritz
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  4. B. Simma
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Correspondence to M. Fritz.

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Fritz, M., Fritsch, P., Foramitti, M. et al. Pulsoxymetriescreening bei Neugeborenen auf kritische angeborene Herzfehler. Monatsschr Kinderheilkd 162, 638–643 (2014). https://doi.org/10.1007/s00112-014-3149-y

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  • DOI: https://doi.org/10.1007/s00112-014-3149-y

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