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Davis NL, Zenchenko Y, Lever A, et al. Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge. Acad Pediatr. 2013;13(3):272-7doi: 10.1016/j.acap.2013.01.009.
Davis, N. L., Zenchenko, Y., Lever, A., & Rhein, L. (2013). Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge. Academic pediatrics, 13(3), 272-7. https://doi.org/10.1016/j.acap.2013.01.009
Davis, Natalie Louise, et al. "Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge." Academic pediatrics vol. 13,3 (2013): 272-7. doi: https://doi.org/10.1016/j.acap.2013.01.009
Davis NL, Zenchenko Y, Lever A, Rhein L. Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge. Acad Pediatr. 2013 May-Jun;13(3):272-7. doi: 10.1016/j.acap.2013.01.009. Epub 2013 Feb 01. PMID: 23680345; PMCID: PMC5669637.
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Acad Pediatr. 2013 May-Jun;13(3):272-7. doi: 10.1016/j.acap.2013.01.009. Epub 2013 Feb 01.

Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge.

Academic pediatrics

Natalie Louise Davis, Yevgeniy Zenchenko, Anthony Lever, Lawrence Rhein

Affiliations

  1. Boston Children's Hospital Division of Newborn Medicine, Boston, MA 02115, USA. [email protected]

PMID: 23680345 PMCID: PMC5669637 DOI: 10.1016/j.acap.2013.01.009

Abstract

BACKGROUND: The American Academy of Pediatrics (AAP) recommends that all preterm neonates undergo a period of observation in a car safety seat before discharge, known as the Infant Car Seat Challenge (ICSC), to monitor for respiratory immaturity and the risk of adverse cardiopulmonary events in the upright position. However, no universal guidelines exist to define appropriate cutoffs for failure of the ICSC. We sought to evaluate regional neonatal intensive care unit (NICU) implementation of the ICSC and to evaluate variation in failure criteria.

METHODS: We contacted level II and III nurseries/NICUs in New York/New England (n = 119) to determine if each performed ICSCs, their inclusion criteria, duration of testing, and failure criteria.

RESULTS: We contacted 119 institutions and had an 87% response rate (n = 103). Of the institutions that responded, 89% (n = 89) perform ICSCs. Of these 89 with current protocols, 17% did not follow AAP guidelines to test all neonates born <37 weeks' gestation, and 45% did not follow guidelines for test duration. Despite wide variation, most units use thresholds for bradycardia of <80 bpm and desaturation of <90% to determine failure.

CONCLUSIONS: Despite AAP guidelines, implementation of ICSCs for preterm neonates is not universal in the region studied. Variation in definition of ICSC failure means that neonates are receiving differential care, not on the basis of their clinical characteristics, but on which institution performs the test. We propose standardizing the test to all infants born at <37 weeks' gestation to a duration of at least 90 minutes, along with a failure threshold for bradycardia of <80 bpm for >10 seconds, and for saturation <90% for >10 seconds.

Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

References

  1. Paediatr Child Health. 2000 Jan;5(1):53-63 - PubMed
  2. Pediatrics. 2010 Mar;125(3):597-8 - PubMed
  3. Pediatrics. 2007 Dec;120(6):1390-401 - PubMed
  4. Pediatrics. 1999 Oct;104(4 Pt 1):986-7 - PubMed
  5. Pediatrics. 1996 Oct;98(4 Pt 1):779-83 - PubMed
  6. Pediatrics. 1996 May;97(5):758-60 - PubMed
  7. Natl Vital Stat Rep. 2011 Nov 3;60(1):1-70 - PubMed
  8. J Pediatr. 1986 Aug;109(2):245-8 - PubMed
  9. N Engl J Med. 2010 May 27;362(21):1959-69 - PubMed
  10. J Pediatr. 2007 Mar;150(3):224-8 - PubMed
  11. Pediatrics. 1985 Feb;75(2):336-9 - PubMed
  12. J Perinat Neonatal Nurs. 2003 Apr-Jun;17(2):158-63 - PubMed
  13. Pediatrics. 1991 Jan;87(1):120-2 - PubMed
  14. Pediatrics. 2010 Aug;126(2):291-7 - PubMed
  15. Pediatrics. 2001 Sep;108(3):647-52 - PubMed
  16. Pediatrics. 2009 May;123(5):1424-9 - PubMed
  17. Pediatrics. 1990 Sep;86(3):486-7 - PubMed
  18. J Pediatr. 1989 Sep;115(3):451-5 - PubMed

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