Pulse Oximetry Screening in the Newborn: Can Modifications to the Screening Algorithm Improve Detection?

Pulse oximetry screening (POS) is a simple non-invasive tool which enables the early detection of critical congenital heart defects (CCHDs). POS has moderate sensitivity and high specificity; it is cost-effective, readily accepted by parents and healthcare professionals, and its introduction significantly reduces mortality from CCHDs. As a result, most high-income countries and many middle-income countries have introduced, or are considering introducing, POS. Despite the international uptake of POS, there is still no consensus regarding the most appropriate screening algorithm, although several have been described. In addition, this review will consider the variations-and their relative advantages and disadvantages-between POS algorithms and also explore how modifications to existing algorithms-such as the addition of a perfusion index or the incorporation of machine learning-may have the potential to improve future detection of CCHDs.