Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain.
BMC Pediatr. 2021 Sep 8;21(Suppl 1):305. doi: 10.1186/s12887-021-02520-7.
We looked at existing recommendations and supporting evidence addressing the effectiveness of pulse oximetry effective for detecting critical congenital heart defects (CCHDs) in newborns. We also looked at the impact of timing of oximetry and the site of testing in the accuracy of screening, and at the potential harms and limitations of pulse oximetry screening,We conducted a literature search up to the 13 of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.Current evidence supports consistent accuracy for detection of CCHDs in newborns by pulse oximetry screening in addition to antenatal ultrasonography and clinical examination. Overall, early diagnosis of CCHD with pulse oximetry is judged to be beneficial and cost-effective, and potential harms associated with false-positive tests are not serious, while missing CCHDs and other serious diseases detected by hypoxaemia in absence of pulse oximetry screening can lead to serious consequences. The site of testing (post-ductal versus pre- and post-ductal) had no significant effect on sensitivity nor specificity for detection of CCHDs.
我们查阅了现有的针对脉搏血氧仪在新生儿中检测严重先天性心脏病（CCHD）有效性的建议和支持证据。我们还研究了血氧测定的时机和检测部位对筛查准确性的影响，以及脉搏血氧测定筛查的潜在危害和局限性。我们使用关键词和选定来源中的手动搜索，对截至 2019 年 8 月 13 日的文献进行了检索。我们根据作者报告的时间和情况总结了建议和推荐强度。我们按照报告的证据确定性总结了系统评价的主要结果。现有证据支持除产前超声和临床检查外，脉搏血氧测定筛查也可用于新生儿 CCHD 的一致准确性。总体而言，通过脉搏血氧测定早期诊断 CCHD 被认为是有益且具有成本效益的，且与假阳性测试相关的潜在危害并不严重，而在没有脉搏血氧测定筛查时因低氧血症漏诊的 CCHD 和其他严重疾病则可能导致严重后果。检测部位（导管后与导管前和导管后）对 CCHD 的检测灵敏度和特异性均无显著影响。
