medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2023, Number 4

<< Back Next >>

Acta Med 2023; 21 (4)

Cardiological screening in newborns in a private hospital in Mexico City; results five years after initiation

López RD, Silva RH, Bernárdez ZI, Rendón MME, Aburto MH

Language: Spanish
References: 30
Page: 343-348
PDF size: 214.61 Kb.


ABSTRACT

Introduction: congenital heart diseases are the second leading cause of mortality in the first year of life in Mexico, prompting their mandatory implementation of all newborns in 2019. Objective: analyze the five-year results of implementing cardiological screening using pulse oximetry (OximP) in a private hospital. Material and methods: an observational, descriptive, retrospective study of all cardiological screenings from 2017 to 2021 was carried out. The results were collected from all the patients in the physiological nursery, considering occasions and moments of screening, as well as the state of maturation and the newborn's skin color. A bivariate analysis of the validity conditions of the screening was performed among the newborns with the χ2 test. A statistical significance level of the p < 0.01. Results: the rate of newborns with suspected critical congenital heart disease (CCHD) was lower than that reported worldwide (≈ 8:5,000). Increasingly lower positivity rates were observed over the years, a statistically significant trend showing that staff training and adequate equipment contributed to the decrease in the frequency of false positive tests. Conclusions: screening using OximP is valuable and specific. However, various factors during the process must be guaranteed for the validity of the results.


REFERENCES

  1. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation. 1971; 43 (3): 323-332.

  2. Instituto Nacional de Estadísticas. Anuarios de demografía y de estadísticas vitales. Chile, 1991-2001.

  3. Valderrama PE, Hernández NI. Concordancia entre ecocardiografía prenatal y postnatal en pacientes con cardiopatías congénitas: Hospital de niños Dr. Roberto del Río. Rev Chil Obstet Ginecol. 2010; 74 (4): 234-239.

  4. Plana MN, Zamora J, Suresh G, Fernandez-Pineda L, Thangaratinam S, Ewer AK. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst Rev. 2018; 3 (3): CD011912.

  5. Atitlán-Gil A, Mendiola-Figueroa LR, Morales-Argüelles VH, Salomón-Ganado A, Medécigo-Castelán E, Erdmenger-Orellana J et al. Implementation of diagnostic screening for congenital heart disease in Hidalgo, Mexico. Arch Cardiol Mex. 2020; 90 (1): 35-41.

  6. Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R et al. Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation. 2009; 120 (5): 447-458.

  7. Lundsgaard C, Van Slyke D, Abbott ME. Cyanosis. Can Med Assoc J. 1923; 13 (8): 601-604.

  8. Ewer AK, Martin GR. Newborn pulse oximetry screening: which algorithm is best? Pediatrics. 2016; 138 (5): e20161206.

  9. Engel MS, Kochilas LK. Pulse oximetry screening: a review of diagnosing critical congenital heart disease in newborns. Med Devices (Auckl). 2016; 9: 199-203.

  10. Narvey M, Wong KK, Fournier A. Pulse oximetry screening in newborns to enhance detection of critical congenital heart disease. Paediatr Child Health. 2017; 22 (8): 494-503.

  11. Orozco GA, Huerta NRI, Marcelo OS. El tamiz cardiológico en la Ciudad de México. ¿Tiene la misma validez que a nivel del mar? Rev Mex Pediatr. 2014; 81 (3): 96-99.

  12. Aamir T, Kruse L, Ezeakudo O. Delayed diagnosis of critical congenital cardiovascular malformations (CCVM) and pulse oximetry screening of newborns. Acta Paediatr. 2007; 96 (8): 1146-1149.

  13. Du C, Liu D, Liu G, Wang H. A Meta-analysis about the screening role of pulse oximetry for congenital heart disease. Biomed Res Int. 2017; 2017: 2123918.

  14. Sola A, Fariña D, Mir R, Garrido D, Pereira A, Montes Bueno MT et al. IX Consenso clínico de SIBEN, Detección precoz de enfermedades que cursan con hipoxemia neonatal mediante el uso de pulsioximetría. Paraguay: EDISIBEN; 2016.

  15. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet. 2012; 379 (9835): 2459-2464.

  16. Zhao QM, Ma XJ, Ge XL, Liu F, Yan WL, Wu L et al. Pulse oximetry with clinical assessment to screen for congenital heart disease in neonates in China: a prospective study. Lancet. 2014; 384 (9945): 747-754.

  17. Jiménez-Carbajal MG, López Pérez D, Fernández Luna CP. Relevancia de la detección de cardiopatías congénitas complejas mediante cribado con oximetría de pulso en recién nacidos aparentemente sanos en los establecimientos de salud. Arch Cardiol Mex. 2018; 88 (4): 298-305.

  18. Campbell MJ, Quarshie WO, Faerber J, Goldberg DJ, Mascio CE, Blinder JJ. Pulse oximetry screening has not changed timing of diagnosis or mortality of critical congenital heart disease. Pediatr Cardiol. 2020; 41 (5): 899-904.

  19. Kluckow M. Barriers to the implementation of newborn pulse oximetry screening: a different perspective. Int J Neonatal Screen. 2018; 4 (1): 4.

  20. Martin GR, Ewer AK, Gaviglio A, Hom LA, Saarinen A, Sontag M et al. Updated strategies for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2020; 146 (1): e20191650.

  21. Mawson IE, Babu PL, Simpson JM, Fox GF. Pulse oximetry findings in newborns with antenatally diagnosed congenital heart disease. Eur J Pediatr. 2018; 177 (5): 683-689.

  22. Wright J, Kohn M, Niermeyer S, Rausch CM. Feasibility of critical congenital heart disease newborn screening at moderate altitude. Pediatrics. 2014; 133 (3): e561-e569.

  23. Oster ME, Aucott SW, Glidewell J, Hackell J, Kochilas L, Martin GR et al. Lessons learned from newborn screening for critical congenital heart defects. Pediatrics. 2016; 137 (5): e20154573.

  24. Mahle WT, Martin GR, Beekman RH 3rd, Morrow WR; Section on Cardiology and Cardiac Surgery Executive Committee. Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2012; 129 (1): 190-192.

  25. Cámara de Diputados. LXIII Legislatura. Que reforma el Artículo 61 de la Ley General de Salud, a cargo del diputado Armando Luna Canales, del grupo parlamentario del PRI. Gaceta Parlamentaria. 2017; 4866-III: 14-19.

  26. Lozano DCM, Hernández BR, Iglesias LJ, Bernárdez ZI, Vidaña PD. Saturación pre y postductal en recién nacidos sanos de la Ciudad de México. Acta Med. 2020; 18 (2): 146-150.

  27. Bickler PE, Feiner JR, Severinghaus JW. Effects of skin pigmentation on pulse oximeter accuracy at low saturation. Anesthesiology. 2005; 102 (4): 715-719.

  28. Cuzzi S, Bradshaw E. The road to universal pulse-oximetry screening: are we there yet? Pediatrics. 2011; 128 (2): e1271-e1272.

  29. Mathew JL, Chawla D, Kumar D. How useful is pulse oximetry for screening of congenital heart disease in newborns? Indian Pediatr. 2014; 51 (11): 913-915.

  30. García Guevara C, García Lugo W, Hernández Martínez Y, Arencibia Faife J, Montes de Oca C. El diagnóstico en el feto cardiópata. An Pediatr Contin. 2012; 10 (6): 324-333.




2020     |     www.medigraphic.com