The Wisconsin SHINE Project
The Wisconsin SHINE Project is part of the Wisconsin Newborn Screening (NBS) Program that provides information and resources about Critical Congenital Heart Disease (CCHD) screening in newborns. Critical Congenital Heart Disease is included in the panel of conditions that all babies born in Wisconsin are screened for through the Newborn Screening Program.
What is Critical Congenital Heart Disease CCHD?
Although there is no perfect definition, the SHINE project defines CCHD as one of twelve diagnoses:
- Hypoplastic Left Heart Syndrome
- Pulmonary Atresia
- Tetralogy of Fallot
- Total Anomalous Pulmonary Venous Return (TAPVR)
- Transposition of the Great Arteries
- Tricuspid Atresia
- Truncus Arteriousus
- Coarctation of the Aorta
- Double Outlet Right Ventricle
- Ebstein’s Anomaly
- Interrupted Aortic Arch
There are somewhere in the neighborhood of 150 babies born in Wisconsin with one of these diagnoses each year.
How do you do the screening?
We recommend using the screening protocol endorsed by the US Secretary of Health and Human Services and the American Academy of Pediatrics. This approach uses a “Two Sites, Three Strikes” approach. Pulse oximetry measurements are made in the right hand and one foot. A baby can have as many as three chances to pass the screening unless one of the oxygen saturations is <90%.
What information is being collected for the SHINE Project?
Record the pulse oximetry result on the newborn screening blood collection card by checking the appropriate box (PASS, FAIL, or NOT SCREENED) and entering the date and time of pulse oximetry screening. Reporting of screening results should NEVER delay the submission of the blood card. This information will be entered into a database similar to the database used to track newborn hearing screens.
Which babies should be screened?
Every baby born in Wisconsin is required to have pulse oximetry screening. Most babies will be screened at the time their newborn blood screen is collected between 24 and 48 hours of life.
Babies who are on supplemental oxygen at the time the newborn blood screen is collected should have pulse oximetry screening deferred until they no longer need supplemental oxygen. Babies being discharged home from the hospital on supplemental oxygen should have pulse oximetry screening close to the time of discharge from the hospital. When a newborn baby is on oxygen for anything other than CCHD, the initial newborn screening blood card should be photocopied and kept in the nursery. When pulse oximetry screening is performed, the results should be recorded on the photocopy of the newborn screening blood card, and the photocopy with the recorded results should be sent to the Wisconsin State Laboratory of Hygiene. This process allows screening for CCHD at a time when the results can be accurately interpreted.
