ArticleHeart views : the official journal of the Gulf Heart Association2026
Should Dual Pulse Oximetry Screening Be Used in Neonates? The Insights from the CHOOSE Study.
Article in Heart views : the official journal of the Gulf Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Critical congenital heart disease (CCHD) is a leading cause of neonatal morbidity and mortality. Early detection is crucial to prevent life-threatening complications. Pulse oximetry screening (POS) is a noninvasive method to identify hypoxemia indicative of CCHD, but the optimal timing for screening remains debated. Aim: To evaluate the diagnostic accuracy of dual POS performed at 24-36 h and 48-72 h of life for early detection of CCHD in neonates. Methods: This prospective observational study was conducted over 20 months at a tertiary care neonatal intensive care unit (NICU) in India. A total of 1431 neonates, including term and preterm, underwent POS at two time points. Screening followed the modified American Academy of Pediatrics algorithm, with echocardiographic follow-up for positive screens. Sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated. Results: Of the enrolled neonates ( Conclusion: Dual POS significantly improves CCHD detection over single screening while identifying treatable noncardiac hypoxemic conditions. This nurse-led protocol is feasible even in resource-constrained NICUs, warranting routine adoption alongside clinical examination to minimize missed diagnoses of CCHD.
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