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Arch Dis Child Fetal Neonatal Ed. 2017 Mar;102(2):F136-F141. doi: 10.1136/archdischild-2016-310730. Epub 2016 Sep 30.

Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle.

Archives of disease in childhood. Fetal and neonatal edition

Renu Arya, Georgina Williams, Anna Kilonback, Martin Toward, Michael Griffin, Peter S Blair, Peter Fleming

Affiliations

  1. Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK.
  2. Institute of Sound and Vibration Research, University of Southampton, Southampton, UK.
  3. School of Social and Community Medicine, University of Bristol, Bristol, UK.

PMID: 27694399 PMCID: PMC5339573 DOI: 10.1136/archdischild-2016-310730

Abstract

BACKGROUND AND OBJECTIVE: The American Academy of Pediatrics recommends that preterm infants complete a predischarge 'car seat challenge' observation for cardiorespiratory compromise while in a car seat. This static challenge does not consider the more upright position in a car or the vibration of the seat when the car is moving. This pilot study was designed to assess the cardiorespiratory effects of vibration, mimicking the effect of being in a moving car, on preterm and term infants.

METHODS: A simulator was designed to reproduce vertical vibration similar to that in a rear-facing car seat at 30 mph. 19 healthy newborn term and 21 preterm infants, ready for hospital discharge, underwent cardiorespiratory measurements while lying flat in a cot (baseline), static in the seat (30°), simulator (40°) and during motion (vibration 40°).

RESULTS: Median test age was 13 days (range 1-65 days) and median weight was 2.5 kg (IQR: 2.1-3.1 kg).Compared with baseline observations, only the total number of desaturations was significantly increased when infants were placed at 30° (p=0.03). At 40°, or with vibration, respiratory and heart rates increased and oxygen saturation decreased significantly. Profound desaturations <85% significantly increased during motion, regardless of gestational age.

CONCLUSIONS: This is the first study to assess the effect of motion on infants seated in a car safety seat. Term and preterm infants showed significant signs of potentially adverse cardiorespiratory effects in the upright position at 40°, particularly with simulated motion, not identified in the standard challenge. A larger study is required to investigate the significance of these results.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Keywords: Injury Prevention; Neonatology

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