Pulse Oximetry for Newborns: January 29, 2014

One of the simplest tests performed on newborns in the hospital may be one of the most valuable. Called pulse oximetry, a cheap, non-invasive test checks for serious heart defects.

“We put an oxygen saturation probe on one of their fingers on their right hand and then another oxygen sat(uration) probe on one of their feet and we just measure their oxygen levels. If there’s a discrepancy or it’s too low, then that prompts us to do further investigation of the heart,” says Dr. Vanessa Gomez, pediatric hospitalist with Golisano Children’s Hospital of Southwest  Florida.

Heart malformations are the most common kind of birth defect, affecting an estimated one out of 100 births worldwide. In 25% of cases, the defects are life threatening. But the diagnosis may be missed, because in the first few days of life nothing may look or sound wrong.

“The signs of a critical congenital heart defect vary tremendously. They vary from a patient being very sick and being cyanotic, or blue, to a patient that looks fine and is feeding okay,” says Dr. Gomez.

Screening costs about a dollar per baby and takes only seconds to perform.

“We like the infant to stay with the mothers at all times, so we take the equipment into the room,” says Carol Lawrence, Program Director with Lee Memorial Health System.

Using a band- aid like wrap with a light sensor inside, technicians look for oxygen levels below 90% or a discrepancy of greater than 3% between hand and foot. These raise a red flag.

“This test has a strong ability to detect infants that have the defect,” says Lawrence.

Most states require a pulse oximetry test before babies go home. Florida does not. But Lee Memorial Health System has made it a system-wide policy.

“The sooner that we identify an infant has a defect, the more appropriate treatment that can be instituted and the better outcome for the infant,” says Lawrence.