Journal Express, Knoxville, IA

Community News Network

April 8, 2014

Fast, cheap test can help save lives of many babies

Olivia Easley gave birth to her third child on April 26, 2009. The baby appeared pink and healthy, nursed well and had gained weight by her first doctor's visit.

But when the baby, Veronica, was about 6 weeks old, she started having difficulty nursing, seemed to be in pain and began vomiting. Her pediatrician thought it might be reflux and suggested that Easley, a physician from Bethesda, Md., who works for the Food and Drug Administration, change her diet.

When things hadn't improved a few days later, Easley scheduled another trip to the pediatrician. That evening, she put Veronica down for a nap after nursing her. Easley heard a bit of crying about an hour later and then silence. Going into the baby's room to check on her, Easley found Veronica flipped onto her stomach. She turned her over - and discovered that her child was not breathing.

"Finding her dead - it's unimaginable," Easley said. "I felt like the floor was ripped out from under me - suddenly floating - you want to escape, and this must be a horrific nightmare. Just seconds before, my life was great and now I'm in hell, and how did this happen?"

Veronica Easley, the medical examiner said, died of total anomalous pulmonary venous connection (TAPVC), one of the heart defects that make up critical congenital heart disease.

 "The medical examiner said it was amazing she lived seven weeks," Easley said. "I was relieved they found something on autopsy, but when I learned more of her condition and that it could have been fixed, I got really angry."

Here's why. As Easley did more research into her daughter's death, she learned that a pilot program had started just months earlier at Holy Cross Hospital in Silver Spring, Md. (Easley had delivered at a different hospital in the Washington area.) The program's goal was to screen every newborn with a simple pulse oximeter test that can help detect heart problems such as Veronica's, allowing doctors to respond. About 40,000 U.S. babies are born every year with congenital heart defects, 400 of them with the deformity that killed Veronica.

The pulse oximeter is a hand-held device that uses a sensor clipped to the fleshy part of a hand or foot to measure oxygen saturation in the blood. It provides noninvasive and low-cost screening that can help detect congenital heart defects that often are associated with abnormally low levels of blood oxygen. According to the American Heart Association, the test takes as little as 45 seconds. When the screening identifies newborns with low oxygen saturation, additional tests can be done to identify and respond to the problem. Pulse oximeters sell online for as little as around $30 for a simple model to more than $200 for a hospital-grade model.

"Congenital heart defects affect one in every 100 live births," said Gerard Martin, a pediatric cardiologist who is senior vice president of the Center for Heart, Lung and Kidney Disease at Children's National Medical Center. If children with critical congenital heart disease do not receive treatment within the first weeks or months of life, the risks of harm or even death can be very high, Martin said. "It's very important for us to find these babies early. If we find them, we can save 98 to 100 percent."

Dylan Coleman, who was born in 2012, may owe his life to the use of a pulse oximeter. His mother, Michelle, delivered the infant at Holy Cross without incident, but as she and her husband were preparing to bring Dylan home two days later, they were told a pulse oximetry test had raised a red flag. (Maryland has required that hospitals administer the tests since 2011.) The hospital performed an echocardiogram that day; when it showed some aortic problems, Dylan was whisked away to Children's for further treatment and surgery. Two weeks later he was discharged and is now doing fine, Coleman says.

"If we had delivered in (Washington) D.C., where we live, he would have been discharged - [hospitals in the District] were not testing at the time," Coleman said. Doctors told her Dylan most likely would have gone into congestive heart failure and died within 48 hours, of being discharged, Coleman said.

Martin said all District hospitals now use pulse oximetry screening as part of a project initiated by Children's. An advisory panel has recommended that the test be mandated.

 Martin said studies 15 years ago first showed the promise of pulse oximetry in detecting cardiac defects in newborns, but more research needed to be done to make the case. A 2009 study of nearly 40,000 infants in Sweden concluded that pulse oximetry screening before discharge was a cost-effective and quite reliable way of detecting potentially serous cardiovascular problems in newborns.

Martin said that in 2009-2010 Children's pulled together pediatricians, neonatologists, nurses, obstetricians and representatives of the FDA, the National Institutes of Health and the Centers for Disease Control and Prevention to look at the issue. The result was a recommendation that the federal government put pulse oximetry on the official list of tests that doctors should regularly perform on newborns. That recommendation was adopted in 2011.

Indiana and Maryland were the first states to mandate universal screening in 2011. As of the beginning of this year, 35 states, including Virginia, have passed legislation requiring testing.

Martin says it's important to get such legislation on the books. "It's a problem that it is not a mandate because this could all go away," he says. "And it doesn't cover the 5 to 6 percent of babies delivered by midwives."

Mairi Breen Rothman of M.A.M.A.S. (Metro Area Midwives & Allied Services) said her organization added pulse oximeters to its Washington area practice a few months ago.

"We felt it was important after Maryland [passed the law requiring pulse oximetry]. We are diligent in our care of babies and didn't want our babies falling through the cracks," said Breen Rothman, a certified nurse-midwife for 18 years.

For Martin, getting people to adopt the test is a no-brainer. Pulse oximetry costs no more than about $1 per baby, yet that early intervention can change lives. "We want to fix them early and fix them right," Martin says.

               

Berger is a freelance journalist who writes about health issues.



 

1
Text Only
Community News Network
  • Wal-Mart to cut prices more aggressively in back-to-school push

    Wal-Mart Stores plans to cut prices more aggressively during this year's back-to-school season and will add inventory to its online store as the chain battles retailers for student spending.

    July 21, 2014

  • Hospitals let patients schedule ER visits

    Three times within a week, 34-year-old Michael Granillo went to the emergency room at Northridge Hospital Medical Center in Los Angeles because of intense back pain. Each time, Granillo, who didn't have insurance, stayed for less than an hour before leaving without being seen by a doctor.

    July 21, 2014

  • Starved Pennsylvania 7-year-old weighed only 25 pounds

    A 7-year-old Pennsylvania boy authorities described as being so underweight he looked like a human skeleton has been released from the hospital.

    July 21, 2014

  • Malaysians wonder 'Why us?' after second loss of airline jet

    It was all too familiar. Grieving families rushing to airport. The flashing television graphics of a plane's last radar appearance. The uncomfortable officials before a heavy thicket of microphones.
    For many Malaysians, the disappearance of Flight 370 in March has been a long trauma from which the nation has not yet recovered.

    July 18, 2014

  • A quarter of the world's most educated people live in the 100 largest cities

    College graduates are increasingly sorting themselves into high-cost, high-amenity cities such as Washington, New York, Boston and San Francisco, a phenomenon that threatens to segregate us across the country by education.

    July 18, 2014

  • Your chocolate addiction is only going to get more expensive

    For nearly two years, cocoa prices have been on the rise. Finally, that's affecting the price you pay for a bar of chocolate - and there's reason to believe it's only the beginning.

    July 18, 2014

  • Facebook tests button to let people shop from its website

    Members on desktop computers or mobile devices can click a "buy" button to make purchases through advertisements or other posts on the world's largest social network, the Menlo Park, California-based company said Thursday in a blog post.

    July 17, 2014

  • The terrible history of passenger planes getting shot out of the sky

    What is more clear is that, if initial reports are true, this would be the deadliest incident of a civilian passenger plane being shot down in modern memory. In some instances, the causes of the disaster are still shrouded in mystery. Here are some of the worst events.

    July 17, 2014

  • 130408_NT_BEA_good kids We're raising a generation of timid kids

    A week ago, a woman was charged with leaving her child in the car while she went into a store. Her 11-year-old child. This week, a woman was arrested for allowing her 9-year-old daughter to go to the park alone. Which raises just one question: America, what the heck is wrong with you?

    July 17, 2014 1 Photo

  • web_starbucks-cof_big_ce.jpg Starbucks sees more Apple-like stores after Colombia debut

    This week Starbucks opened its first location in Colombia — a 2,700-square-foot store with a heated patio, concrete columns, mirrors on the ceiling and walls of colorful plants.

    July 17, 2014 1 Photo

Features
AP Video
Veteran Creates Job During High Unemployment Widow: Jury Sent Big Tobacco a $23B Message $5M Bond Set for Teens in Homeless Killings New Orleans Plans to Recycle Cigarette Butts UN Security Council Calls for MH 17 Crash Probe Obama Bestows Medal of Honor on NH Veteran Texas Sending National Guard Troops to Border Hopkins to Pay $190M After Pelvic Exams Taped Foxx Cites Washington 'Circus Mirror' NASA Ceremony Honors Moon Walker Neil Armstrong Obama Voices Concern About Casualties in Mideast Obama Calls for Immediate Access to Crash Site Obama Protects Gay, Transgender Workers US Teen Beaten in Mideast Talks About Ordeal Shark Sightings a Big Catch for Cape Tourism Native American Teens Get Taste of College Legendary Actor James Garner Dies Raw: Eric Garner's Wife Collapses at Rally in NY Raw: Texas Gov. Rick Perry Visits Iowa Raw: High Winds Push Growing Washington Widlfire
Facebook
Hyperlocal Search
Premier Guide
Find a business

Walking Fingers
Maps, Menus, Store hours, Coupons, and more...
Premier Guide
Poll

Upon completion and reopening of Third Street, should the City of Knoxville wait to start the next stage of the Streetscape and Infrastructure project until 2015?

Yes
No
     View Results