Beschreibung:
<jats:title>Abstract</jats:title><jats:p><jats:italic>Aim</jats:italic>: To evaluate the feasibility of detecting duct‐dependent congenital heart disease before hospital discharge by using pulse oximetry. <jats:italic>Design</jats:italic>: Case‐control study. <jats:italic>Setting</jats:italic>: A supra‐regional referral centre for paediatric cardiac surgery in Sweden. <jats:italic>Patients</jats:italic>: 200 normal term newborns with echocardiographically normal hearts (median age 1.0 d) and 66 infants with critical congenital heart disease (CCHD; median age 3 d).</jats:p><jats:p><jats:italic>Methods:</jats:italic> Pulse oximetry was performed in the right hand and one foot using a new‐generation pulse oximeter (NGoxi) and a conventional‐technology oximeter (CToxi).</jats:p><jats:p><jats:italic>Results:</jats:italic> With the NGoxi, normal newborns showed a median postductal saturation of 99% (range 94–100%); intra‐observer variability showed a mean difference of 0% (SD 1.3%), and inter‐observer variability was 0% (SD 1.5%). The CToxi recorded a significantly greater proportion of postductal values below 95% (41% vs 1%) in the normal newborns compared with NGoxi (<jats:italic>p</jats:italic> < 0.0001). The CCHD group showed a median postductal saturation of 90% (45–99%) with the NGoxi. Analysis of distributions suggested a screening cut‐off of < 95%; however, this still gave 7/66 false‐negative patients, all with aortic arch obstruction. Best sensitivity was obtained by adding one further criterion: saturation of < 95% in both hand and foot or a difference of > ± 3% between hand and foot. These combined criteria gave a sensitivity of 98.5%, specificity of 96.0%, positive predictive value of 89.0% and negative predictive value of 99.5%.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> Systematic screening for CCHD with high accuracy requires a new‐generation oximeter, and comparison of saturation values from the right hand and one foot substantially improves the detection of CCHD.</jats:p>