Does Auscultation Make a Difference If We Are Using Pulse Oximetry for Newborn Screening of Critical Congenital Heart Disease? :

The role for pulse oximetry as a newborn screen for detection of critical congenital heart disease (CCHD) is well defined at this point, but this method of screening will not detect every CCHD lesion especially if these lesions are not ones that cause hypoxemia. Thus Hu et al, (10.1542/peds.2017-1154) wondered if adding cardiac auscultation could improve the sensitivity of pulse oximetry (POX) as a screening method for asymptomatic CCHD.  The authors share the results of a multicenter prospective observation study involving 15 hospitals in Shanghai from 2012 to 2014. They defined an infant as screening positive if they had an abnormal POX or cardiac auscultatory exam.  Anyone positive then underwent an echo.  Over 167,000 infants were consecutively screened and 203 were found to have CCHD with a 1% false positive rate. The addition of auscultation significantly improved the detection of CCHD in early infancy. Just how much did it improve the screen and what diseases were detected—take heart and link to this study where you will learn a lot more and perhaps consider making sure auscultation remains a critical part of your newborn cardiac screen since by this study, it can make a difference!