Beissel Daniel J, Goetz Elizabeth M, Hokanson John S
Department of Pediatrics, American Family Children' s Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-4108, USA.
Congenit Heart Dis. 2012 Sep-Oct;7(5):460-5. doi: 10.1111/j.1747-0803.2012.00651.x. Epub 2012 Apr 12.
Pulse oximetry can be used as a screening tool to detect critical congenital heart disease (CCHD) in neonates prior to hospital discharge and the development of symptoms. Newborns suspected of having CCHD based on pulse oximetry screening should have the diagnosis excluded or confirmed with echocardiography. However, echocardiography is not immediately available in all settings in which newborns are delivered and the best course of action in these settings remains to be determined. The purpose of this study was to evaluate the resources available to diagnose and treat newborns with CCHD born in the state of Wisconsin.
We surveyed the nurse managers or administrators of the 99 Wisconsin hospitals in which babies are routinely delivered in the state of Wisconsin. A telephone survey was performed in February and March 2011. The number of births per facility was estimated from the most recent available data (2010).
There were 66 179 total births occurring in 106 hospitals in the state of Wisconsin in 2010, with 99 hospitals routinely delivering newborns. Surveys were completed in 88/99 (88.9%), representing 95% of the state's in-hospital births. All responding hospitals had pulse oximetry available in the nursery. Twenty-five of 88 (28.4%) of responding hospitals routinely use pulse oximetry to screen for CCHD, representing 35.2% of surveyed hospital births. Same-day neonatal echocardiography was available at 33/88 (37.5%) of the responding hospitals, representing 74.4% of surveyed hospital births. The average distance to the higher-level care facility of choice from the hospitals without neonatal echocardiography is 53.1 miles.
Pulse oximetry is universally available in Wisconsin newborn nurseries, and pulse oximetry screening for CCHD is currently being performed for many of Wisconsin's newborns. The majority of births in Wisconsin occur in hospitals where same-day neonatal echocardiography is available for confirmatory diagnosis of CCHD when necessary.
脉搏血氧饱和度测定可作为一种筛查工具，在新生儿出院前且症状出现之前检测严重先天性心脏病（CCHD）。基于脉搏血氧饱和度筛查怀疑患有CCHD的新生儿，应用超声心动图排除或确诊该诊断。然而，并非所有接生新生儿的场所都能立即进行超声心动图检查，在这些场所的最佳行动方案仍有待确定。本研究的目的是评估威斯康星州出生的患有CCHD的新生儿的诊断和治疗可用资源。
我们调查了威斯康星州99家常规接生婴儿的医院的护士长或管理人员。2011年2月和3月进行了电话调查。每个机构的出生人数根据最新可得数据（2010年）估算。
2010年威斯康星州106家医院共有66179例分娩，其中99家医院常规接生新生儿。88/99（88.9%）完成了调查，占该州住院分娩的95%。所有回复的医院在新生儿病房都配备了脉搏血氧饱和度测定仪。88家回复医院中有25家（28.4%）常规使用脉搏血氧饱和度测定仪筛查CCHD，占调查医院分娩的35.2%。33/88（37.5%）回复医院可提供当日新生儿超声心动图检查，占调查医院分娩的74.4%。没有新生儿超声心动图检查的医院到首选的高级护理机构的平均距离为53.1英里。
脉搏血氧饱和度测定仪在威斯康星州的新生儿病房普遍可用，目前许多威斯康星州的新生儿正在进行CCHD的脉搏血氧饱和度测定筛查。威斯康星州的大多数分娩发生在必要时可进行当日新生儿超声心动图检查以确诊CCHD的医院。
