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Pediatr Cardiol. 2008 Jan;29(1):142-5. doi: 10.1007/s00246-007-9065-3. Epub 2007 Sep 05.

Prehospital discharge car safety seat testing of infants after congenital heart surgery.

Pediatric cardiology

J M Simsic, K Masterson, B E Kogon, P M Kirshbom, K Kanter

Affiliations

  1. Sibley Heart Center Cardiology, 2835 Brandywine Road, Suite 300, Atlanta, GA 30341, USA. [email protected]

PMID: 17786375 DOI: 10.1007/s00246-007-9065-3

Abstract

BACKGROUND: This study aimed to expand the American Academy of Pediatrics (AAP) car safety seat testing recommendation to include high-risk infants after cardiac surgery.

METHODS: Car safety seat testing (< or =4 days before discharge), performed according to AAP guidelines, was retrospectively reviewed for 66 postoperative infants. Failure was defined as apnea, bradycardia, or oxygen desaturation.

RESULTS: The average birth weight of the study infants was 3.1 +/- 0.5 kg. Two patients were born at less than 37 weeks gestation. Surgical procedures included modified Blalock-Taussig shunt technique (n = 15), arterial switch operation (n = 12), Norwood Sano modification (n = 11), coarctation repair (n = 8), repair of tetralogy of Fallot (n = 6), repair of truncus arteriosus (n = 4), repair of total anomalous pulmonary venous return (n = 3), pacemaker placement (n = 2), repair of interrupted aortic arch and ventriculoseptal defect (VSD) (n = 1), repair of coarctation and VSD (n = 1), orthotopic heart transplant (n = 1), repair of VSD (n = 1), and patent ductus arteriosus ligation (n = 1). The average age at discharge was 28 +/- 21 days. Four patients (6%) failed car safety seat testing because of a fall in oxygen saturation. One of the four patients passed on retesting after parental education, whereas three of the four (75%) were discharged home in a supine car safety seat. There was no relationship between the type of surgery and car safety seat test failure.

CONCLUSION: It may be beneficial to extend the AAP recommendations for car safety seat testing to include high-risk infants after cardiac surgery.

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