Original articleCar Seat or Car Bed for Very Low Birth Weight Infants at Discharge Home
Section snippets
Population
To increase the sample size and the generalizability of the findings, the study was conducted in two hospitals: Parkland Memorial Hospital (Dallas, Texas), a county hospital with a largely inborn population, and Memorial Hermann Children’s Hospital (Houston, Texas), a private hospital with a substantial proportion of maternal and neonatal referrals. All VLBW infants weighing ≤1500 g at birth and at <37 weeks’ gestational age (GA) became eligible when they were nearing discharge. At both
Results
Between February and December 2002, 178 infants met inclusion criteria. Consent was obtained for 160, and 7 were not studied because they were discharged earlier than planned. The data could not be analyzed for two infants because of monitor malfunction. Thus, we assessed 151 infants; 77 were randomly assigned to the car seat first and 74 to the car bed first. The median (range) birth weight was 1120 g (437 to 3105); weight at study, 2545 g (1750 to 5670); GA at birth, 29 weeks (24 to 34); and
Discussion
To our knowledge, this is the first randomized study comparing responses of infants to car beds and car seats. Our study has three major findings: (1) As reported by other investigators,2, 3, 4, 5 apnea, bradycardia, and desaturation episodes may still occur at discharge when VLBW infants are placed in a transportation device, particularly among infants who were born most prematurely or who are recovering from BPD; (2) we found no evidence that these episodes are less likely in a car bed than a
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Cited by (21)
A National Survey of Car Seat Tolerance Screening Protocols in Neonatal Intensive Care Units
2021, Academic PediatricsCritical congenital heart disease screening does not predict car seat tolerance screen outcomes
2018, Journal of Neonatal NursingCitation Excerpt :The CSTS screen lasts much longer (90–120 min vs. ∼10 min), so unless the neonate is having persistent desaturations or bradycardia, a shorter test may miss events. Salhab et al. showed that 40% of those who had an event in the car seat did so after 60 min of observation (Salhab et al., 2007). In addition, while the etiology of desaturations in CHD is known (abnormal shunting of deoxygenated blood), the etiology of CSTS events remains unclear.
Car Seat Tolerance Screening in the Neonatal Intensive Care Unit: Failure Rates, Risk Factors, and Adverse Outcomes
2018, Journal of PediatricsCitation Excerpt :In apparent contravention of the AAP recommendation, 1.9% of tested infants were discharged without a record of passing the CSTS.9 Prior studies describing the incidence of CSTS failure among preterm infants reported failure rates ranging from 4.3% to as high as 83%.6,7,10,14,16,17,29-33 Consistent with our findings, the 2 prior largest studies on this topic found CSTS failure rates of 4.3% and 5.5% among infants with gestational ages of <37 weeks.10,14
Car seat safety for preterm neonates: Implementation and testing parameters of the Infant Car Seat Challenge
2013, Academic PediatricsCitation Excerpt :Increasing length of time in the car seat position has been associated with decreased saturations.13,15 In one study looking at ICSCs lasting 120 minutes, the proportion of infants whose first event occurred after 60 minutes of observation was 40%, and after 90 minutes of observation was 30%.15 A shorter testing duration may therefore miss episodes of desaturation or bradycardia.
The Challenge of Positional Car Seat Testing in Healthy Near-term Neonates
2007, Newborn and Infant Nursing ReviewsThe Challenge of Car Safety Seats
2007, Journal of Pediatrics
Equipment was supplied by CAS Medical Systems Inc and Cosco.