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Combining Pulse Oximetry and Clinical Examination in Screening for Congenital Heart Disease

机译：结合脉搏血氧饱和度和临床检查筛查先天性心脏病

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摘要

The objective of this study was to evaluate combined pulse oximetry and clinical examination as a screening method for congenital heart disease (CHD) in asymptomatic newborns. Asymptomatic newborns were screened for CHD using pulse oximetry and clinical examination before their discharge from the nursery. Oxygen saturation ≥94% was considered normal. Echocardiography was done for newborns with abnormal readings and for those with significant murmurs. Data concerning undetected cases were collected from the pediatric referral hospital. A total of 5211 cases were screened. Echocardiographic evaluations were done based on low pulse oximetry in five cases and on murmur detection in ten others. The sensitivity of the combined method of screening was 77%, whereas it was 31% for oximetry alone and 46% for clinical examination alone. Specificity was ∼100% for all methods. The positive predictive value of the combined tool was 66.7%. We conclude that combining pulse oximetry and clinical examination can enhance the clinician’s ability to detect life-threatening CHD in a timely manner. This screening method should become a part of the discharge plan for every newborn.
机译：这项研究的目的是评估无创新生儿先天性心脏病（CHD）的筛查方法，结合脉搏血氧饱和度和临床检查。无症状新生儿在出院前，使用脉搏血氧饱和度测定法和临床检查对CHD进行筛查。氧饱和度≥94％被认为是正常的。对读数异常和杂音明显的新生儿进行超声心动图检查。有关未发现病例的数据是从儿科转诊医院收集的。总共筛选了5211例病例。超声心动图评估是基于低脉搏血氧饱和度法（5例）和杂音检测（另10例）。联合筛查方法的敏感性为77％，而单独的血氧测定法为31％，单独的临床检查法为46％。所有方法的特异性均为〜100％。组合工具的阳性预测值为66.7％。我们得出的结论是，将脉搏血氧仪和临床检查相结合可以提高临床医生及时发现威胁生命的冠心病的能力。这种筛查方法应成为每个新生儿出院计划的一部分。

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