TUCSON, Ariz. – In a report published online Aug. 21 in The Journal of Pediatrics, physicians recommend a pulse oximetry screening – a simple, pain-free test for newborns to check for signs of congenital heart disease. One of the most common types of birth defects, congenital heart disease occurs in almost 1 of every 100 births in the United States, with an estimated 200 infants dying each year because of undiagnosed, unrecognized cases.
Pulse oximetry screening, which has been standard practice at University Medical Center in Tucson for the past five years, now is endorsed by the American Academy of Pediatrics, the American College of Cardiology Foundation and the American Heart Association.
“Diamond Children's at UMC adopted a pulse oximetry screening program five years ago and we are the only hospital in Tucson doing this,” says Scott E. Klewer, MD, professor of pediatrics (cardiology), University of Arizona Steele Children’s Research Center investigator, UA Sarver Heart Center member and chief of staff at University Medical Center. “It was started at UMC thanks to a Sarver Heart Center award to one of our past pediatric residents, Dr. Mike Seckeler, who is now a pediatric cardiologist in Virginia.”
The seed grant was the William J. “Billy” Gieszl Endowed Award for Heart Research, established by the Gieszl family of Phoenix in memory of their young son and brother who died from congenital heart disease.
After the pilot project, UMC leadership (led by Vicki Began, RN, vice president and chief nursing officer) was convinced that pulse ox screening should be included in the quality care of newborns at UMC. “The nursery staff felt the added costs of screening all newborns was easily justified by the increased peace of mind and satisfaction for parents,” says Dr. Klewer.
The pulse oximetry screening identifies newborns with Cyanotic Congenital Heart Disease (CCHD), which occurs when oxygen-rich blood mixes with venous blood, resulting in an excess of deoxygenated blood in the system. These defects often result in heart failure and even death in untreated infants. Newborns with CCHD can present with bluish skin coloration, which makes diagnosis likely. For babies with CCHD who don’t show any symptoms, pulse oximetry can help doctors diagnose this deadly condition.
“Thanks to advances in obstetric ultrasound, most infants with cyanotic heart conditions are identified prior to birth. However, since the pilot program began at UMC in 2005, we have identified approximately one ‘asymptomatic’ child with a heart problem in the normal newborn nursery each year through this program with very few ‘false positives’ that required a heart ultrasound before discharge,” says Dr. Klewer, who mentored Dr. Seckeler. About 3,000 babies are born at Diamond Children’s at UMC each year.