Clinical Assistant Assessment (CAA)
18-10
18.6 CCHD (Critical Congenital Heart Disease) Screening
The pulse-oximetry monitoring can be used for screening for critical congenital heart disease (CCHD). CCHD
screening primarily targets seven specific lesions: hypoplastic left heart syndrome, pulmonary atresia, Tetralogy of
Fallot (TOF), total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia and
truncus arteriosus.
This Monitor provides two set of CCHD sceening rules: American Standard and Two Standards:
American Standard recommends that the screening for CCHD should be carried out on neonates between 24 and
28 hours after birth. Neonates who are less than 24 hours old and waiting to be discharged from the hospital should
be screened for CCHD as soon as possible. The CCHD is carried out by measuring the neonatal patient’s right hand
and one foot for SpO
2
values, and then comparing the difference between these two values for ΔSpO
2.
Two Standards uses pulse oximetry combined with cardiac auscultation in screeing for CCHD, which is
recommended to be carried out to the neonates between 6 -72 hours after birth by measuring both the neonatal
patient’s right hand and one foot for SpO
2
values and comparing these two values for ΔSpO
2
, and combining the
heart murmur level for final results.
CCHD screening is only applicable to neonatal patients.
18.6.1 CCHD Detection procedure
American Standard, one of the screening rules provided in this monitor, comes from the neonatal screening
procedures recommended by a working group composed of the members designated by Secretary’s Advisory
Committee on Heritable Disorders in Newborns and Children (SACHDNC), American Academy of Pediatrics (AAP),
American College of Cardiology Foundation (ACCF) and American Heart Association (AHA). The procedure is shown
below:
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