Beau Redwood, Adrian Tarca, Zac Dempsey, Rebecca Thomas, Cameron Seaman, Simon Erickson, Stephen Shipton, Deane Yim
Perth Children’s Hospital. Kids Research Institute Australia.
Australia
Heart Lung and Circulation
Heart Lung Circ 2026;
DOI: 10.1016/j.hlc.2025.12.028
Abstract
Background: Simultaneous pre/post-ductal oxygen saturation measurements are routinely performed in neonates with suspected congenital heart disease (CHD) however, there is significant variability in physician practices and perceived clinical utility of differential oxygen saturation monitoring in individual CHD lesions.
Method: A survey of Australian and New Zealand paediatric cardiologists, neonatologists and paediatric intensivists was conducted to obtain multi-centre, multi-disciplinary physician opinion regarding the utility of pre/post-ductal oxygen saturation monitoring in various clinical situations.
Results: Overall, 111 responses were received, 32 from paediatric cardiologists, 61 from neonatologists and 18 from paediatric intensivists. In neonates with any form of CHD, 38.7% of participants reported that simultaneous pre/post-ductal oxygen saturation monitoring was often/always useful, 51.4% reported sometimes useful, and 9.9% reported never/rarely useful. There were variations in practice within and between specialities, though the overall differences in utility between specialties were not statistically significant. Participants reported the greatest utility in transposition of the great arteries with intact ventricular septum (TGA/IVS), left heart obstructive lesions and persistent pulmonary hypertension (PPHN), and the least utility in intracardiac shunts, truncus arteriosus, obstructed total anomalous pulmonary venous drainage and right heart obstructive lesions.
Conclusions: Pre/post-ductal oxygen saturation monitoring in neonates with CHD can provide useful clinical information regarding patient physiology in select lesions where a differential might occur, including left heart obstructive lesions, TGA/IVS and PPHN. Opinion and practice among paediatric cardiologists, neonatologists and paediatric intensivists regarding its utility is variable and lesion-dependent, overall and within specialties. We suggest the utility of pre/post-ductal oxygen saturation monitoring is limited to specific lesions and should not be used in all neonates with CHD.
Category
Class I. Pulmonary Hypertension Associated with Congenital Cardiovascular Disease
Class I. Persistent Pulmonary Hypertension of the Newborn
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
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