6010 The impact and outcome of newborn pulse oximetry screening in a district general hospital

Objectives Objectives- Routine Newborn pulse oximetry screening identifies babies with critical congenital heart defects (CCHD) which can be missed on antenatal ultrasound and postnatal examination as well as non-cardiac causes of hypoxemia.1 This facilitates early detection and intervention which reduces mortality from CCHD. According to a newborn pulse oximetry screening in the UK – a 2020 survey, the Uptake of Pulse oximetry screening (POS) varies in UK with 51% noted in England 100% in Wales.1 78% of the units felt that it did not lead to increase in number of unnecessary investigations.Although the yield is low,10% of the units felt that small increase in investigations was justified and offset by the benefits of identifying cardiac and noncardiac pathologies.1 'The need for a national recommendation is more compelling than ever'.1 We conducted an audit to assess the impact and outcome of newborn pulse oximetry screening following implementation of a new local guideline. Methods A retrospective observational study was carried out from October 2021- October 2022. Data was collected retrospectively from NIPE Smart s4n SYSTEM and BADGERNET maternity system for all eligible babies born at 34 weeks and above gestation. A positive screen is pre-ductal or post-ductal saturations below 95% or a difference of >2%. If the baby was asymptomatic this was repeated on 3 separate occasions at hourly intervals and reviewed by middle grade doctor.2 Results The sample size was 3619 babies of which 3533 were screened, that is 97.6% compliance. Babies with positive pulse oximetry screen are reviewed by neonatal registrar and if asymptomatic screening is repeated in 1 hour. If symptomatic or if either `reading 2%, a comprehensive evaluation for causes of hypoxaemia is undertaken. The number of babies with positive POS -22 The number of babies with 2nd screen negative was 21/22(95.4%). The baby with positive screen was admitted to the neonatal unit and had sepsis as underlying cause.2/22(9%) of the babies were reviewed by a middle grade doctor.19/22(86.4%) of the babies were reviewed by senior house officer.1/22 (4.5%) was reviewed by a midwife. Conclusion Over the first year of implementation of local guideline, The POS did not impact the workload nor increase the echo cardiograms or other investigations. There was no impact on admissions and parental anxiety. There was one positive screen which led to an early detection of sepsis which highlights the benefits of the screening for identification of non-cardiac cause of hypoxemia. In the following year, the screening led to early detection of a cardiac cause which warranted urgent transfer to a cardiac center for intervention. References Brown S, Liyanage S, Mikrou P, Singh A, Ewer AK. Newborn pulse oximetry screening in the UK: a 2020 survey. The Lancet, 2020;396(10255):881. Newborn Pulse oximetry screening guideline Kings College Hospital NHS Foundation Trust.