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
Affiliations
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK.
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK.
- 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.
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Keywords: Injury Prevention; Neonatology
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