Pediatric Pulmonology Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
Acta Paediatr. 2013 Apr;102(4):379-84. doi: 10.1111/apa.12155. Epub 2013 Jan 28.
To determine the normal SpO2 in healthy term newborns at mild altitude (MA, 780 metres) compared with sea level (SL), within the context of universal screening for critical congenital heart disease (CCHD).
We studied 199 (119 at MA and 80 at SL) consecutively born healthy newborns. SpO2 recordings were at 24-72 h using Masimo SET Radical-7 on the right hand and left foot.
Mean SpO2 was lower at MA compared with SL in the right hand (97.86 ± 1.58 vs 98.28 ± 1.41, p = 0.05) and left foot (98.49 ± 1.35 vs 98.90 ± 1.16, p = 0.03). No infant with SpO2 <95% had CCHD. Extrapolating with predicted regression lines set at 95% CI, a SpO2 cut-off of 95% would result in up to 3.5 times more false-positive screens at MA compared with SL.
At MA, SpO2 is approximately 0.4% lower compared with SL. Our study supports the AAP recommendation suggesting algorithm cut-offs may need adjustment in high-altitude nurseries and suggest broadening it to MA as well.
在普遍筛查先天性心脏病（CCHD）的背景下，确定轻度海拔（MA，780 米）与海平面（SL）相比健康足月新生儿的正常 SpO2。
我们研究了 199 名（MA 组 119 名，SL 组 80 名）连续出生的健康新生儿。在右手上和左脚上使用 Masimo SET Radical-7 在 24-72 小时内记录 SpO2。
与 SL 相比，MA 组右手（97.86 ± 1.58 对 98.28 ± 1.41，p = 0.05）和左脚（98.49 ± 1.35 对 98.90 ± 1.16，p = 0.03）的 SpO2 较低。没有 SpO2 <95%的婴儿患有 CCHD。根据 95%CI 设置的预测回归线外推，与 SL 相比，MA 的 SpO2 截断值为 95%，假阳性筛查结果将增加约 3.5 倍。
在 MA 时，SpO2 比 SL 低约 0.4%。我们的研究支持 AAP 建议，即建议在高海拔托儿所调整算法截断值，并建议将其扩大到 MA。
