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https://www.readbyqxmd.com/read/27810158/clinical-outcomes-associated-with-a-failed-infant-car-seat-challenge
#1
Malika D Shah, Keith A Dookeran, Janine Y Khan
OBJECTIVE: To assess comorbid conditions and clinical outcomes among late preterm and low birth weight term infants (<2.5 kg) who failed the Infant Car Seat Challenge (ICSC) on the Mother-Baby Unit. STUDY DESIGN: This was a retrospective chart review of consecutive infants who failed ICSC on the Mother-Baby Unit and were subsequently admitted to the neonatal intensive care unit at Prentice Women's Hospital between January 1, 2009, and December 31, 2015. Regression models were used to estimate risk differences (RDs) with 95% CIs for factors related to length of stay...
October 31, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27694399/is-the-infant-car-seat-challenge-useful-a-pilot-study-in-a-simulated-moving-vehicle
#2
Renu Arya, Georgina Williams, Anna Kilonback, Martin Toward, Michael Griffin, Peter S Blair, Peter Fleming
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...
September 30, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27398056/assessment-of-cardiorespiratory-stability-using-the-infant-car-seat-challenge-before-discharge-in-preterm-infants-37-weeks-gestational-age
#3
Michael R Narvey
Preterm infants younger than 37 weeks corrected gestational age are at increased risk for abnormal control of respiration. The infant car seat challenge has been used as a screening tool to ensure cardiorespiratory stability before discharging preterm infants from many hospitals in Canada. While it is clear that infants placed in a car seat are more likely to experience oxygen desaturation and/or bradycardia than when they are supine, neither positioning predicts an adverse neurodevelopmental outcome or mortality post-discharge...
April 2016: Paediatrics & Child Health
https://www.readbyqxmd.com/read/26941555/factors-associated-with-car-seat-test-failure-in-late-preterm-infants-a-retrospective-chart-review
#4
Ryan W Smith, Adel Mohamed, Jennifer Young, Ann Jefferies, Vibhuti Shah
BACKGROUND: Professional organizations recommend car seat testing of preterm infants before discharge from hospital. Late preterm infants (LPIs, 34(0/7) to 36(6/7) weeks' gestational age) are at the greatest risk for failure, despite often being well. OBJECTIVE: To determine the incidence of car seat testing failure in LPIs and associative factors. METHODS: A retrospective chart review was performed of inborn LPIs admitted to all levels of newborn care between July 1, 2012 and June 30, 2013...
January 2016: Paediatrics & Child Health
https://www.readbyqxmd.com/read/25675050/screening-for-cardiopulmonary-events-in-neonates-a-review-of-the-infant-car-seat-challenge
#5
REVIEW
N L Davis
The infant car seat challenge (ICSC), or period of observation in a car safety seat before discharge to monitor for episodes of apnea, bradycardia and desaturation, is one of the most common tests performed on preterm neonates in the United States. However, the utility of the ICSC to identify infants at risk for adverse cardiopulmonary events in the car seat remains unclear. Minimal evidence exists to guide clinicians in performance of this test including appropriate inclusion criteria and failure criteria...
April 2015: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/23858423/randomized-controlled-trial-of-a-car-safety-seat-insert-to-reduce-hypoxia-in-term-infants
#6
RANDOMIZED CONTROLLED TRIAL
Christine G McIntosh, Shirley L Tonkin, Alistair Jan Gunn
OBJECTIVE: To test the hypothesis that a foam plastic insert that allows the infant head to rest in a neutral position in sleep may prevent obstruction of the upper airway and thus reduce episodes of reduced oxygenation in term infants in car seats. METHODS: Healthy full-term babies were randomized to be studied during sleep while restrained in an infant car safety seat either with or without the insert, with continuous polysomnographic recordings with sleep video...
August 2013: Pediatrics
https://www.readbyqxmd.com/read/23680345/car-seat-safety-for-preterm-neonates-implementation-and-testing-parameters-of-the-infant-car-seat-challenge
#7
Natalie Louise Davis, Yevgeniy Zenchenko, Anthony Lever, Lawrence Rhein
BACKGROUND: The American Academy of Pediatrics (AAP) recommends that all preterm neonates undergo a period of observation in a car safety seat before discharge, known as the Infant Car Seat Challenge (ICSC), to monitor for respiratory immaturity and the risk of adverse cardiopulmonary events in the upright position. However, no universal guidelines exist to define appropriate cutoffs for failure of the ICSC. We sought to evaluate regional neonatal intensive care unit (NICU) implementation of the ICSC and to evaluate variation in failure criteria...
May 2013: Academic Pediatrics
https://www.readbyqxmd.com/read/23402887/a-comparison-of-the-infant-car-seat-challenge-and-the-polysomnogram-at-the-time-of-hospital-discharge
#8
COMPARATIVE STUDY
David L Schutzman, Agnes Salvador, Michael Janeczko, Louis Weisberg, Nghia Tran, Rachel Porat
OBJECTIVE: The American Academy of Pediatrics recommends all infants born at <37 weeks gestation spend a period of observation in a car seat prior to hospital discharge to assess for apnoea, bradycardia or oxygen desaturation. The most recent Cochrane review suggested further studies to determine if the infant car seat challenge (ICSC) accurately predicts the risk of clinically adverse events. We reviewed our experience with the ICSC and the polysomnogram (PSG) to determine if the ICSC accurately predicts the risk of adverse events when compared with the PSG...
September 2013: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/19706572/a-comparison-of-respiratory-patterns-in-healthy-term-infants-placed-in-car-safety-seats-and-beds
#9
RANDOMIZED CONTROLLED TRIAL
Lilijana Kornhauser Cerar, Christina V Scirica, Irena Stucin Gantar, Damjan Osredkar, David Neubauer, T Bernard Kinane
OBJECTIVE: The purpose of this work was to compare the incidence of apnea, hypopnea, bradycardia, or oxygen desaturation in healthy term newborns placed in hospital cribs, infant car safety beds, or infant car safety seats. METHODS: A consecutive series of 200 newborns was recruited on the second day of life. Each subject was studied while placed in the hospital crib (30 minutes), car bed (60 minutes), and car seat (60 minutes). Physiologic data, including oxygen saturation, frequency, and type of apnea, hypopnea, and bradycardia were obtained and analyzed in a blinded manner...
September 2009: Pediatrics
https://www.readbyqxmd.com/read/19309252/effect-of-sitting-position-on-respiratory-status-in-preterm-infants
#10
Mika Shiraishi, Kyoko Hirasawa, Satoru Shimizu, Hiroshi Nishida, Makiko Osawa
OBJECTIVE: To evaluate whether using a sitting-type car safety seats for preterm infants is advisable. PATIENTS AND METHODS: A total of 65 preterm infants underwent polysomnography in the supine and sitting positions. The infants with <95% of SpO(2) were assigned to the desaturation (DS) group. Their backgrounds, breathing patterns, and breathing types were analyzed. RESULTS: Of the 65 cases, 18 were assigned to the DS group. No significant differences were observed between the DS and non-DS groups in their background characteristics...
2009: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/18052992/can-we-reduce-episodes-of-haemoglobin-desaturation-in-full-term-babies-restrained-in-car-seats
#11
Shirley L Tonkin, Christine G McIntosh, Gillian M Nixon, Simon Rowley, Alistair J Gunn
OBJECTIVES: To determine whether episodes of haemoglobin oxygen (SpO2) desaturation in full-term infants restrained in car seats can be reduced by a simple foam plastic infant car seat insert designed to push the body forward, with space for the protuberant occiput to lie behind the spine, and so reduce flexion of the infant's head on the trunk. METHODS: Eighteen healthy full-term babies were evaluated while restrained in an infant car safety seat with, and without, the foam insert...
January 2008: Acta Paediatrica
https://www.readbyqxmd.com/read/17786375/prehospital-discharge-car-safety-seat-testing-of-infants-after-congenital-heart-surgery
#12
J M Simsic, K Masterson, B E Kogon, P M Kirshbom, K Kanter
BACKGROUND: This study aimed to expand the American Academy of Pediatrics (AAP) car safety seat testing recommendation to include high-risk infants after cardiac surgery. METHODS: Car safety seat testing (< or =4 days before discharge), performed according to AAP guidelines, was retrospectively reviewed for 66 postoperative infants. Failure was defined as apnea, bradycardia, or oxygen desaturation. RESULTS: The average birth weight of the study infants was 3...
January 2008: Pediatric Cardiology
https://www.readbyqxmd.com/read/17674081/pre-hospital-discharge-car-safety-seat-testing-in-infants-following-congenital-heart-surgery
#13
COMPARATIVE STUDY
J M Simsic, K Masterson, B E Kogon, P M Kirshbom, K R Kanter
The purpose of this study was to expand the American Academy of Pediatrics' (AAP) car safety seat testing recommendation to include high-risk infants following cardiac surgery. Car safety seat testing (< or =4 days prior to discharge) was retrospectively reviewed for 66 postoperative infants. Car safety seat testing was performed according to AAP guidelines. Failure of the test was defined as the occurrence of apnea, bradycardia, or oxygen desaturation. Average birth weight was 3.1 +/- 0.5 kg. Two patients were born <37 weeks of gestation...
March 2008: Pediatric Cardiology
https://www.readbyqxmd.com/read/17594403/stability-of-the-infant-car-seat-challenge-and-risk-factors-for-oxygen-desaturation-events
#14
Michele DeGrazia
OBJECTIVES: To explore the stability of the one-point Infant Car Seat Challenge and risk factors that may be associated with oxygen desaturation events. DESIGN, SETTING, AND PARTICIPANTS: This descriptive, nonexperimental, observational study examined the responses of 49 premature infants during two 90-minute Infant Car Seat Challenges at a tertiary health care institution. MAIN OUTCOME MEASURES: Three Infant Car Seat Challenge outcomes were explored: (a) pass/fail rates following two Infant Car Seat Challenge observation periods, (b) oxygen saturation and desaturation patterns during two Infant Car Seat Challenges, and (c) the association between oxygen desaturation events and infants' chronological, gestational, and corrected gestational ages...
July 2007: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/17307533/car-seat-or-car-bed-for-very-low-birth-weight-infants-at-discharge-home
#15
COMPARATIVE STUDY
Walid A Salhab, Asif Khattak, Jon E Tyson, Sharon Crandell, Jan Sumner, Beverly Goodman, Linda Fisher, Karen Robinson
OBJECTIVE: To compare the incidence of apnea, bradycardia, or desaturation in a car seat with that in a car bed for preterm very low birth weight (< or = 1500 g) infants. STUDY DESIGN: Infants were studied for 120 minutes in a car seat and in a car bed. Apnea (> 20 seconds), bradycardia (heart rate < 80/min for > 5 seconds), desaturation (SpO2 < 88% for > 10 seconds), and absent nasal flow were monitored. RESULTS: We assessed 151 infants (median birth weight, 1120 g [range, 437 to 3105]; median birth gestational age, 29 weeks [24 to 34]) in both devices...
March 2007: Journal of Pediatrics
https://www.readbyqxmd.com/read/16437530/pre-discharge-car-seat-challenge-for-preventing-morbidity-and-mortality-in-preterm-infants
#16
REVIEW
E Pilley, W McGuire
BACKGROUND: Physiological monitoring studies indicate that some preterm infants experience episodes of oxygen desaturation, apnoea, or bradycardia when seated in standard car safety seats. The American Academy of Pediatrics recommends that all preterm infants should be assessed for cardiorespiratory stability in their car seat prior to discharge - the "car seat challenge". We aimed to assess the evidence to support this practice, specifically to determine whether the use of the car seat challenge prevents morbidity and mortality in preterm infants...
2006: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/16244205/the-car-seat-a-challenge-too-far-for-preterm-infants
#17
REVIEW
E Pilley, W McGuire
Physiological monitoring studies have shown that some preterm infants who are otherwise ready for hospital discharge experience episodes of oxygen desaturation, apnoea, or bradycardia when seated in standard car safety seats. The American Academy of Pediatrics recommends that all preterm infants are assessed for cardiorespiratory stability in their car seat before discharge: the "car seat challenge". This screening test has been incorporated into discharge assessments in most neonatal units in North America and is being increasingly used in the United Kingdom and elsewhere...
November 2005: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/16042768/risk-of-cardio-respiratory-abnormalities-in-preterm-infants-placed-in-car-seats-a-cross-sectional-study
#18
Vallier C Ojadi, Anna Petrova, Rajeev Mehta, Thomas Hegyi
BACKGROUND: Little is known about the factors that predispose to the occurrence and severity of cardio-respiratory symptoms during the placement of a prematurely born infant in a car seat. The impact of gestational age, weight at discharge and infant's pre-existing cardio-respiratory status (in the supine position) on cardio-respiratory function during pre-discharge testing in a car seat (semi-upright position) has not been investigated. METHODS: The cardio-respiratory function of 42 preterm neonates with gestational age 24 to 35 weeks and discharge weight 1790 to 2570 grams were monitored for 45 minutes before, during, and after placement in a car seat...
2005: BMC Pediatrics
https://www.readbyqxmd.com/read/14523185/simple-car-seat-insert-to-prevent-upper-airway-narrowing-in-preterm-infants-a-pilot-study
#19
Shirley L Tonkin, Christine G McIntosh, Wendy Hadden, Caroline Dakin, Simon Rowley, Alistair J Gunn
OBJECTIVES: To test prospectively the hypothesis that an infant car seat modification to allow the infant's head to rest in a neutral position on the trunk would prevent narrowing of the upper airway and thus reduce oxygen desaturation in preterm infants who are restrained in car seats. METHODS: Seventeen preterm infants who were approved for discharge were evaluated in a car seat for newborns, with and without a foam insert that provided a slot for the back of the infants' head...
October 2003: Pediatrics
https://www.readbyqxmd.com/read/12822703/car-seat-challenges-where-are-we-in-implementation-of-these-programs
#20
Linda E Williams, Jeanne E Martin
Premature infants and infants with special needs are being discharged home at smaller weights and earlier postconceptional ages. This presents a challenge to safely transporting these infants in car seats. Car seat technology has not kept abreast of advances experienced in neonatal medical technology. Several studies have demonstrated that preterm infants are at risk for apnea, bradycardia, and oxygen desaturations while being transported in traditional car seats. The American Academy of Pediatrics issued policy statements recommending that all infants less than 37 weeks of gestational age be monitored in a car seat safety test prior to discharge...
April 2003: Journal of Perinatal & Neonatal Nursing
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