G531(P)?Effect on cardiorespiratory function in term and preterm infants sitting in a car safety seat, in a simulated moving vehicle (pilot study)

Arya, R., Williams, G., Kilonback,, A., Toward, Martin G.R., Griffin, M.J., Fleming, P. and Blair, P. (2014) G531(P)?Effect on cardiorespiratory function in term and preterm infants sitting in a car safety seat, in a simulated moving vehicle (pilot study). Archives of Disease in Childhood, 99, supplement 1, A55. (doi:10.1136/archdischild-2014-306237.131).

Abstract

Introduction: the AAP recommends preterm infants undergo a “car seat challenge” before discharge, to observe for any differences in cardiorespiratory function whilst seated in a car seat compared to lying flat in a cot. The infant can be discharged if there is no compromise. This static (30°) challenge does not take into account the more vertical positioning of the seat or effects of vibration when it is secured in a moving vehicle.

Aim: to investigate the effect of vibration, mimicking that experienced in a moving car, on cardio-respiratory function, compared to the standard challenge.

Methods: a novel simulator was designed to represent the vibrations felt in a rear facing car seat during a normal urban cycle. 40 term & preterm babies, ready for discharge after birth, were recruited. The babies were their own control. Observations of heart & respiratory rates, saturation & end tidal CO2 levels were recorded flat in a cot, static in the seat (30°) & simulator (40°) & during vibration (motion).

Results: 19 term & 21 preterm infants were tested; 22 were male (55%). Gestation range was 25+2 weeks to 41+5 weeks (median 35+5). Median birthweight was 2.5 kg (range 0.8 kg to 4.8 kg). Age at testing was 1 to 65 days (median 13 days).

There were no significant differences in outcome variables for infants in the cot & 30° position. However, compared to rest, in the static 40° position infants had significantly faster heartbeats, lower oxygen saturation & higher respiratory rates. When in motion these differences persisted & the number of desaturations below 85% were significantly higher.

Conclusions: testing all infants at 30° would suggest they could travel. However both term & preterm babies showed signs of cardio-respiratory distress in the 40° position with a significant increase in profound desaturations during motion, which were underestimated by the standard challenge

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Contributors

Author: Martin G.R. Toward

Author: M.J. Griffin

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