Access and Quality of CareCar Seat Safety for Preterm Neonates: Implementation and Testing Parameters of the Infant Car Seat Challenge
Section snippets
Methods
We identified all existing level II and III NICUs in New England (including Connecticut, Maine, New Hampshire, Rhode Island, and Massachusetts) and New York using the 2011 AAP Section on Perinatal Pediatrics Directory of Newborn Intensive Care Units. Because there is very little information available on ICSC practices in the United States in general, we chose to focus on a narrow geographic area to assess regional agreement in testing parameters. We focused on level II and III nurseries because
Results
The survey was conducted between December 2011 and May 2012. Of the 119 qualifying institutions, 103 (87%) responded to our requests for information about their ICSC policy. Of the 103 responding institutions, 11 (11% of respondents) did not perform ICSC testing. This included 4 level II units (14% of level II units that responded) and 7 level III units (9% of level III units that responded). We found that 3 sites performed ICSCs but were in the process of updating their policy and did not
Discussion
Our survey assessed adherence to AAP guidelines for ICSC testing and attempted to identify consensus eligibility and failure criteria among level II and III NICUs in New England and New York. Our high survey response rate (87%) ensured excellent representation of the region, and we were able to identify a number of key issues related to ICSC testing. First, a large number of NICUs do not adhere to current AAP guidelines either by not performing ICSC testing, by having more restrictive
Acknowledgments
The authors would like to thank all of the institutions who took the time to participate in our survey. Research support for Dr Natalie Louise Davis was provided by the Ruth L. Kirschstein National Research Service Award (T32), PHS grant 2 T32 7466-16.
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Cited by (27)
Discontinuation of Car Seat Tolerance Screening and Postdischarge Adverse Outcomes in Infants Born Preterm
2023, Journal of PediatricsA National Survey of Car Seat Tolerance Screening Protocols in Neonatal Intensive Care Units
2021, Academic PediatricsCitation Excerpt :However, there was wide variation in whether additional inclusion criteria were used and if so, what these criteria were. A BW cutoff was used by 55% of responding NICUs, which is consistent with a prior regional survey.17 A study focusing on term low birth weight infants found a similar CSTS failure incidence (4.8%) as has been demonstrated in studies of preterm infants.12
Clinically Asymptomatic Sleep-Disordered Breathing in Infants with Single-Ventricle Physiology
2020, Journal of PediatricsCitation Excerpt :The oxygen saturation and heart rate used to determine failure of a standard Car Seat Challenge included an oxygen saturation ≥10% reduction from awake baseline oxygen saturations for >10 seconds and/or heart rate ≤80 bpm for >10 seconds. The standard Car Seat Challenge variables used for this study were based on findings of a study performed by Davis et al.17 Participant characteristics were described using means and SDs and frequencies and percentages.
Car Seat Tolerance Screening in the Neonatal Intensive Care Unit: Failure Rates, Risk Factors, and Adverse Outcomes
2018, Journal of PediatricsCitation Excerpt :In addition, the Optum database does not include information on how CSTS was performed and how “failure” was defined. These test characteristics may vary widely between centers.22 We evaluated 46 a priori defined individual and categorical maternal and infant characteristics as potential independent risk factors for CSTS failure.
Clinical Outcomes Associated with a Failed Infant Car Seat Challenge
2017, Journal of PediatricsCitation Excerpt :From 2012 to 2015, 2215 car seat tests were performed on the Mother-Baby Unit with a failure rate of 4.5% (100 ICSC failures). This number is consistent with previous published reports showing a range of 4%-36% for ICSC failure.3,8,9 We observed that continuous monitoring of infants who fail this test revealed a high incidence of apnea, approaching almost one-half of infants born at 35-<37 weeks gestation.