336 Pulse Oximetry Screening for Detection of Critical Congenital Heart Disease in the United Kingdom

Abstract

Background and aims: Pulse oximetry screening (POS) has been proposed as an effective and non invasive screening tool to increase the detection of critical congenital heart disease (cCHD). The objective of our survey was to assess the current practice in UK neonatal units.Methods: Level 3 and level 2 units in the UK were contacted to participate in a telephonic questionnaire in April 2010.Results: All 135 units contacted agreed to participate in the survey.20(15%) units are currently practising routine POS. POS is usually performed before 24 hours in all units either by a trained nurse or doctor. Four centres were part of a multicentric trial in 2008-09. Saturation of < 95% in either limb (right hand or any foot) or ≥ 3% difference between the two is considered significant (positive). In the remaining 16 centres postductal saturation of < 95% in the foot is considered positive. A second reading is obtained in all positive cases within next 2 hours and if still positive, a senior review followed by early echocardiogram is undertaken. All units expressed that a saturation reading of < 90% in a baby who has no other obvious cause warranted an urgent echocardiogram.Conclusion: Two large trials in Europe have recommended that POS should be used as an adjunct to postnatal examination to improve detection of cCHD. Our survey shows that a minority of centres are practising POS in UK and are using different crtieria. With mounting evidence, all units should consider adopting POS as a scrrening tool.