Protocol Updates 2025
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.
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?
Core CCHD conditions detected by screening using pulse oximetry include:
- 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
Approximately 100 babies are born in Wisconsin with one of these diagnoses each year.
What other conditions can CCHD screening identify?
A secondary benefit of CCHD screening using pulse oximetry is the identification of hypoxemic conditions other than CCHD. These are identified as secondary conditions (non-CCHD). Early identification and treatment of these conditions are important.
- Hemoglobinopathy
- Hypothermia
- Infection, including sepsis
- Lung disease (congenital or acquired)
- Non-critical congenital heart disease
- Persistent pulmonary hypertension
- Other hypoxic conditions not otherwise specified
How do you do the screening?
Original screening recommendations were updated in 2024. (“Updated Recommendations” – please make this a link to publication) Screening for CCHD should take place between 24-48 hours of life with pulse oximetry measurements in right hand (pre-ductal) and one foot (post-ductal). If pulse oximetry measurements are greater than or equal to 95% in both hand and foot this is a PASS. If pulse oximetry is less than 90% in the hand or foot this is a FAIL. If pulse oximetry is 90-94% in the hand or foot this is a REPEAT. The test can be repeated one time one hour later. At that time if pulse oximetry in either the right hand or foot is less than 95% the baby has FAILED the screen.
How are screening results reported?
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 newborns 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.
Every newborn in Wisconsin is required to have pulse oximetry screening. Most newborns will be screened at the time their newborn blood screen is collected between 24 and 48 hours of life.
Newborns 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.Newborns being discharged home from the hospital on supplemental oxygen should have an echocardiogram and do not require pulse oximetry screening. Newborns who have an echocardiogram prior to the recommended screening time do not need pulse oximetry screening.
