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Newborn oxygen saturation at mild altitude versus sea level: implications for neonatal screening for critical congenital heart disease
Author(s) -
Samuel Tal Y.,
Bromiker Reuben,
Mimouni Francis B.,
Picard Elie,
Lahav Sigalit,
Mandel Dror,
Goldberg Shmuel
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12155
Subject(s) - medicine , heart disease , oxygen saturation , pediatrics , cardiology , effects of high altitude on humans , altitude (triangle) , oxygen , anatomy , chemistry , geometry , mathematics , organic chemistry
Aim To determine the normal SpO 2 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. SpO 2 recordings were at 24–72 h using Masimo SET Radical‐7 on the right hand and left foot. Results Mean SpO 2 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 SpO 2 <95% had CCHD. Extrapolating with predicted regression lines set at 95% CI, a SpO 2 cut‐off of 95% would result in up to 3.5 times more false‐positive screens at MA compared with SL. Conclusions At MA, SpO 2 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.