Han Lucy M, Klewer Scott E, Blank Karin M, Seckeler Michael D, Barber Brent J
College of Medicine, The University of Arizona, Tucson, AZ, USA.
Pediatr Cardiol. 2013;34(8):1803-7. doi: 10.1007/s00246-013-0716-2. Epub 2013 May 16.
To evaluate the feasibility of implementing a pulse oximetry screening protocol at a city of mild elevation with a specific focus on the false-positive screening rate. Pulse oximetry screening was performed according to the proposed guidelines endorsed by the American Academy of Pediatrics at a center in Tucson, AZ, at an elevation of 2,643 ft (806 m). During a 10-month period in 2012, 1069 full-term asymptomatic newborns were screened ≥ 24 h after birth. The mean preductal oxygen saturation was 98.5 ± 1.3 % (range 92-100 %), and the mean postductal oxygen saturation was 98.6 ± 1.3 % (range 94-100 %). Of 1,069 patients screened, 7 were excluded secondary to protocol violations, and 1 screened positive. An echocardiogram was performed on the newborn with the positive screen, and it was normal with the exception of right-to-left shunting across a patent foramen ovale. The false-positive rate was 1/1,062 or 0.094 %. The pulse oximetry screening guidelines recommended by the American Academy of Pediatrics are feasible at an elevation of 2,643 ft (806 m) with a low false-positive rate. Adjustments to the protocol are not required for centers at elevations ≤ 2,643 ft. Future studies at greater elevations are warranted.
为评估在轻度海拔城市实施脉搏血氧饱和度筛查方案的可行性,特别关注假阳性筛查率。在亚利桑那州图森市海拔2,643英尺(806米)的一个中心,按照美国儿科学会认可的拟议指南进行脉搏血氧饱和度筛查。在2012年的10个月期间,对1069名出生后≥24小时的足月无症状新生儿进行了筛查。导管前平均血氧饱和度为98.5±1.3%(范围92 - 100%),导管后平均血氧饱和度为98.6±1.3%(范围94 - 100%)。在1069名接受筛查的患者中,7名因违反方案被排除,1名筛查呈阳性。对筛查呈阳性的新生儿进行了超声心动图检查,除卵圆孔未闭存在右向左分流外,结果正常。假阳性率为1/1,062或0.094%。美国儿科学会推荐的脉搏血氧饱和度筛查指南在海拔2,643英尺(806米)处可行,假阳性率低。海拔≤2,643英尺的中心无需对方案进行调整。有必要对更高海拔进行进一步研究。
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