Narvey Michael, Wong Kenny K, Fournier Anne
Canadian Paediatric Society, Fetus and Newborn Committee, Ottawa, Ontario.
Paediatr Child Health. 2017 Nov;22(8):494-503. doi: 10.1093/pch/pxx136. Epub 2017 Nov 27.
Pulse oximetry screening is safe, noninvasive, easy to perform and proven to enhance detection of critical congenital heart disease in newborns. However, this test has yet to be adopted as routine practice in Canada. The present practice point highlights essential details and recommendations for screening, which research has shown to be highly specific, with low false-positive rates. Optimal screening for critical congenital heart disease should include prenatal ultrasound, physical examination and pulse oximetry screening. Screening should be performed between 24 hours and 36 hours postbirth, using the infant's right hand and either foot to minimize false-positive results. Newborns with abnormal results should undergo a thorough evaluation by the most responsible health care provider. When a cardiac diagnosis cannot be excluded, referral to a paediatric cardiologist for consultation and echocardiogram is advised.
脉搏血氧饱和度筛查安全、无创、操作简便，且已被证明可提高新生儿重症先天性心脏病的检出率。然而，这项检测在加拿大尚未成为常规做法。本实践要点强调了筛查的基本细节和建议，研究表明这些细节和建议具有高度特异性，假阳性率低。重症先天性心脏病的最佳筛查应包括产前超声检查、体格检查和脉搏血氧饱和度筛查。筛查应在出生后24小时至36小时之间进行，使用婴儿的右手和任意一只脚，以尽量减少假阳性结果。结果异常的新生儿应由最负责的医疗保健提供者进行全面评估。当不能排除心脏诊断时，建议转诊至儿科心脏病专家进行咨询并进行超声心动图检查。
