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新生儿脉搏血氧筛查以检测严重先天性心脏病。

Newborn pulse oximetry screening to detect critical congenital heart disease.

机构信息

Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI.

Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI.

出版信息

J Pediatr. 2014 Mar;164(3):505-9.e1-2. doi: 10.1016/j.jpeds.2013.10.065. Epub 2013 Dec 5.

Abstract

OBJECTIVES

To describe current practice and clarify provider opinion in the US with regard to newborn pulse oximetry screening (NPOx) for critical congenital heart disease.

STUDY DESIGN

An internet-based questionnaire was forwarded to general pediatricians, neonatologists, and family medicine physicians. Physicians were surveyed regarding involvement in newborn medicine, knowledge of NPOx recommendations, and opinions regarding screening. NPOx protocol specifics were also queried.

RESULTS

Survey responses (n = 481) were received with 349 respondents involved in newborn medicine. Forty-nine percent (95% CI 44%-54%) of those involved in newborn medicine practice at a hospital with a NPOx protocol. Sixty-six percent of providers endorsed it as an effective tool, 20% required more education, 11% questioned its sensitivity, and 3% had no opinion. Sixty-five percent of providers were aware of recent state legislation mandating its use and 46% reported awareness of the addition of NPOx to the Recommended Uniform Screening Panel. Eighty-four percent of providers who practice at a hospital without a NPOx protocol were interested in its implementation. NPOx protocols varied and were not uniform with differences in time of test, location of probe, and values considered positive.

CONCLUSIONS

NPOx has grown in its prevalence and acceptance in clinical practice, yet is far from universal in its application and design despite the recent American Academy of Pediatrics endorsement and its addition to the Recommended Uniform Screening Panel. The majority of physicians involved in newborn medicine deemed it an effective tool.

摘要

目的

描述美国目前在新生儿脉搏血氧饱和度筛查(NPOx)用于筛查严重先天性心脏病方面的实践情况,并阐明提供者的意见。

研究设计

采用基于互联网的问卷调查方式,向普通儿科医生、新生儿科医生和家庭医学医生发送问卷。调查医生在新生儿医学方面的参与情况、对 NPOx 建议的了解程度以及对筛查的意见。还询问了 NPOx 方案的具体细节。

结果

共收到 481 份调查回复,其中 349 名医生参与了新生儿医学。在有 NPOx 方案的医院中,有 49%(95%CI 44%-54%)的新生儿医学参与医生参与了该方案。66%的提供者认为它是一种有效的工具,20%的提供者需要更多的教育,11%的提供者对其敏感性提出质疑,3%的提供者没有意见。65%的提供者了解最近州立法要求使用该方案,46%的提供者报告了解将 NPOx 添加到推荐的统一筛查面板中。84%的在没有 NPOx 方案的医院执业的提供者对其实施感兴趣。NPOx 方案存在差异,且测试时间、探头位置和认为阳性的数值等方面并不统一。

结论

尽管最近美国儿科学会对此表示认可,并将其添加到推荐的统一筛查面板中,但 NPOx 在临床实践中的应用越来越广泛,且被越来越多的人接受,但它的应用和设计还远未普及。大多数参与新生儿医学的医生认为它是一种有效的工具。

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