Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle
Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle
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.
F136-F141
Arya, Renu
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Williams, Georgina
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Kilonback, Anna
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Toward, Martin
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Griffin, Michael
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Blair, Peter S.
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Fleming, Peter
9d81be68-1699-420e-a3f1-1d7f3ba28c2c
1 March 2017
Arya, Renu
27c0468b-21df-46fe-b986-3e517ff7fdd4
Williams, Georgina
53818b0a-127d-408b-a221-af581e11b3da
Kilonback, Anna
8c2805c1-76b1-46e4-9bf2-79b8a5731259
Toward, Martin
1d10e993-e6ef-449d-bccb-1f8198169bee
Griffin, Michael
24112494-9774-40cb-91b7-5b4afe3c41b8
Blair, Peter S.
3d5e258e-a342-4f3f-98a3-195267ee7456
Fleming, Peter
9d81be68-1699-420e-a3f1-1d7f3ba28c2c
Arya, Renu, Williams, Georgina, Kilonback, Anna, Toward, Martin, Griffin, Michael, Blair, Peter S. and Fleming, Peter
(2017)
Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle.
Archives of Disease in Childhood: Fetal and Neonatal Edition, 102 (2), .
(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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Accepted/In Press date: 27 June 2016
e-pub ahead of print date: 30 September 2016
Published date: 1 March 2017
Organisations:
University of Southampton
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Local EPrints ID: 406284
URI: http://eprints.soton.ac.uk/id/eprint/406284
ISSN: 1359-2998
PURE UUID: 0a83ecda-bddf-481f-993c-d175780cccda
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Date deposited: 10 Mar 2017 10:44
Last modified: 16 Mar 2024 03:17
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Author:
Renu Arya
Author:
Georgina Williams
Author:
Anna Kilonback
Author:
Martin Toward
Author:
Michael Griffin
Author:
Peter S. Blair
Author:
Peter Fleming
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