de-Wahl Granelli Anne, Meberg Alf, Ojala Tiina, Steensberg Jesper, Oskarsson Gylfi, Mellander Mats
Department of Paediatric Cardiology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Paediatrics, Vestfold Hospital Trust, Tønsberg, Norway.
Acta Paediatr. 2014 Nov;103(11):1136-42. doi: 10.1111/apa.12758. Epub 2014 Aug 24.
Pulse oximetry screening of newborn infants increases early detection of critical congenital heart disease and minimises the risk of circulatory collapse before surgery. This study provides an update on the implementation of pulse oximetry screening in the Nordic countries and proposes standardised guidelines.
A questionnaire exploring pulse oximetry screening, clinical examination routines and availability of echocardiography was distributed to all 157 delivery units in the Nordic countries in June 2013.
We received responses from 156 of the 157 delivery units, and 116 (74%) were using pulse oximetry screening by September 2013. Preductal and postductal screening were both used in 59 of 116 units (51%), with just postductal screening in 51 of 116 (44%) and just preductal screening alone in 6 of 116 (5%). Screening was performed before 24 h in 105 of 116 units (91%). The implementation of screening was highest in Finland (29/30, 97%), Sweden (42/46, 91%) and Norway (43/48, 90%) and lowest in Denmark (2/24, 8%) and Iceland (0/8 units).
In Sweden, Norway and Finland, the implementation of pulse oximetry screening is currently the highest in the world and coverage will be close to 100% in 2014. We propose uniform Nordic guidelines using preductal and postductal screening before 24 h of age.
对新生儿进行脉搏血氧饱和度筛查可提高对严重先天性心脏病的早期检测,并将手术前循环衰竭的风险降至最低。本研究提供了北欧国家脉搏血氧饱和度筛查实施情况的最新信息,并提出了标准化指南。
2013年6月,向北欧国家的所有157个分娩单位发放了一份调查问卷,内容涉及脉搏血氧饱和度筛查、临床检查常规以及超声心动图的可获得性。
我们收到了157个分娩单位中156个单位的回复,到2013年9月,有116个单位(74%)正在使用脉搏血氧饱和度筛查。116个单位中有59个(51%)同时使用了出生前和出生后筛查,116个中有51个(44%)仅使用出生后筛查,116个中有6个(5%)仅使用出生前筛查。116个单位中有105个(91%)在出生后24小时内进行了筛查。芬兰(29/30,97%)、瑞典(42/46,91%)和挪威(43/48,90%)的筛查实施率最高,丹麦(2/24,8%)和冰岛(0/8个单位)的实施率最低。
在瑞典、挪威和芬兰,脉搏血氧饱和度筛查的实施率目前是世界上最高的,2014年覆盖率将接近100%。我们建议采用统一的北欧指南,在出生后24小时内同时进行出生前和出生后筛查。