Oxygen Saturation and Perfusion Index-Based Enhanced Critical Congenital Heart Disease Screening

Abstract

Objective: To determine if addition of perfusion index (PIx) to oxygen saturation (SpO₂) screening improves detection of critical congenital heart disease (CCHD) with systemic outflow obstruction.

Study design: We determined screening thresholds for PIx and applied these to a cohort of newborns with and without congenital heart disease (CHD).

Results: A total of 123 normal and 21 CHD newborns (including five with critical systemic outflow obstruction) were enrolled. Four of these five critical systemic obstruction subjects passed SpO₂-based screen. Four out of these five subjects failed PIx-based screen. The sensitivity for detection of systemic obstruction CCHD when compared with healthy infants increased from 20% (95% confidence interval [CI]: 1-72%) with SpO₂ screening alone to 80% (95% CI: 28-100%) with combined SpO₂-PIx screen. However, 2.44% of normal infants failed PIx screen.

Conclusion: Addition of PIx to SpO₂ screening may detect additional cases of CCHD and further research is necessary to come up with optimal screening thresholds.