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Newborn oxygen saturation at mild altitude versus sea level: implications for neonatal screening for critical congenital heart disease.

Abstract

AIM

To determine the normal SpO2 in healthy term newborns at mild altitude (MA, 780 metres) compared with sea level (SL), within the context of universal screening for critical congenital heart disease (CCHD).

METHODS

We studied 199 (119 at MA and 80 at SL) consecutively born healthy newborns. SpO2 recordings were at 24-72 h using Masimo SET Radical-7 on the right hand and left foot.

RESULTS

Mean SpO2 was lower at MA compared with SL in the right hand (97.86 ± 1.58 vs 98.28 ± 1.41, p = 0.05) and left foot (98.49 ± 1.35 vs 98.90 ± 1.16, p = 0.03). No infant with SpO2 <95% had CCHD. Extrapolating with predicted regression lines set at 95% CI, a SpO2 cut-off of 95% would result in up to 3.5 times more false-positive screens at MA compared with SL.

CONCLUSIONS

At MA, SpO2 is approximately 0.4% lower compared with SL. Our study supports the AAP recommendation suggesting algorithm cut-offs may need adjustment in high-altitude nurseries and suggest broadening it to MA as well.

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  • Authors+Show Affiliations

    ,

    Pediatric Pulmonology Unit, Shaare Zedek Medical Center, Jerusalem, Israel.

    , , , , ,

    Source

    MeSH

    Altitude
    Female
    Heart Defects, Congenital
    Humans
    Infant, Newborn
    Israel
    Male
    Neonatal Screening
    Oximetry
    Oxygen
    Reference Values

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    23298328

    Citation

    Samuel, Tal Y., et al. "Newborn Oxygen Saturation at Mild Altitude Versus Sea Level: Implications for Neonatal Screening for Critical Congenital Heart Disease." Acta Paediatrica (Oslo, Norway : 1992), vol. 102, no. 4, 2013, pp. 379-84.
    Samuel TY, Bromiker R, Mimouni FB, et al. Newborn oxygen saturation at mild altitude versus sea level: implications for neonatal screening for critical congenital heart disease. Acta Paediatr. 2013;102(4):379-84.
    Samuel, T. Y., Bromiker, R., Mimouni, F. B., Picard, E., Lahav, S., Mandel, D., & Goldberg, S. (2013). Newborn oxygen saturation at mild altitude versus sea level: implications for neonatal screening for critical congenital heart disease. Acta Paediatrica (Oslo, Norway : 1992), 102(4), pp. 379-84. doi:10.1111/apa.12155.
    Samuel TY, et al. Newborn Oxygen Saturation at Mild Altitude Versus Sea Level: Implications for Neonatal Screening for Critical Congenital Heart Disease. Acta Paediatr. 2013;102(4):379-84. PubMed PMID: 23298328.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Newborn oxygen saturation at mild altitude versus sea level: implications for neonatal screening for critical congenital heart disease. AU - Samuel,Tal Y, AU - Bromiker,Reuben, AU - Mimouni,Francis B, AU - Picard,Elie, AU - Lahav,Sigalit, AU - Mandel,Dror, AU - Goldberg,Shmuel, Y1 - 2013/01/28/ PY - 2012/09/19/received PY - 2012/12/11/revised PY - 2013/01/03/accepted PY - 2013/1/10/entrez PY - 2013/1/10/pubmed PY - 2013/10/29/medline KW - Congenital heart defects KW - neonatal screening KW - pulse oximetry SP - 379 EP - 84 JF - Acta paediatrica (Oslo, Norway : 1992) JO - Acta Paediatr. VL - 102 IS - 4 N2 - AIM: To determine the normal SpO2 in healthy term newborns at mild altitude (MA, 780 metres) compared with sea level (SL), within the context of universal screening for critical congenital heart disease (CCHD). METHODS: We studied 199 (119 at MA and 80 at SL) consecutively born healthy newborns. SpO2 recordings were at 24-72 h using Masimo SET Radical-7 on the right hand and left foot. RESULTS: Mean SpO2 was lower at MA compared with SL in the right hand (97.86 ± 1.58 vs 98.28 ± 1.41, p = 0.05) and left foot (98.49 ± 1.35 vs 98.90 ± 1.16, p = 0.03). No infant with SpO2 <95% had CCHD. Extrapolating with predicted regression lines set at 95% CI, a SpO2 cut-off of 95% would result in up to 3.5 times more false-positive screens at MA compared with SL. CONCLUSIONS: At MA, SpO2 is approximately 0.4% lower compared with SL. Our study supports the AAP recommendation suggesting algorithm cut-offs may need adjustment in high-altitude nurseries and suggest broadening it to MA as well. SN - 1651-2227 UR - https://www.unboundmedicine.com/medline/citation/23298328/Newborn_oxygen_saturation_at_mild_altitude_versus_sea_level:_implications_for_neonatal_screening_for_critical_congenital_heart_disease L2 - https://doi.org/10.1111/apa.12155 DB - PRIME DP - Unbound Medicine ER -