The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

DO HEALTHY PRETERM INFANTS MAINTAIN RESPIRATORY STABILITY IN CAR SAFETY SEATS?

Catherine T Worwa CRRT, JR Merchant MD, R deRegnier MD, S Porter RRT, JM Coleman MD. Children's Hospital-St. Paul, Minnesota.

Introduction: There is little data on respiratory stability in car seats of healthy preterm (PT) infants, not requiring NICU care. The purpose of this study was to evaluate these healthy PT infants as compared to a control group of term (T) infants.

Methods: Infants were recruited from the newborn nursery. PT infants were 35-36 weeks using best obstetrical criteria for dates. Controls were ³37 weeks using the same criteria. Parents' car seats were used unless the car seat did not meet current safety standards or dimensions were not suitable for a newborn. Edentec Assurance 2000 apnea monitors with memory and Nellcor N3000 pulse oximeters were used. Baseline values were obtained with infants positioned supine for 30 minutes, they were then placed in their car seat with supporting blanket rolls for an additional 90 minutes. Significant events were defined as apnea >20 seconds, bradycardia < 80 bpm for ³ 4 seconds, or desaturation <85% for ³ 4 seconds.

Results: Twenty-six infants were evaluated (13 PT and 13 T). Mean birthweight (BW) for the PT infants was 2520 ± 486g and 3437 ± 1048g for controls. Mean postnatal age was 3.8 ± 1.7 days (range 1-7) for PT infants and 2.6 ± 1.7 days (range 1-7) for controls. Eighteen percent of car seats furnished by parents were unacceptable. Six of 13 PT and 2 of 13 T infants met criteria for significant events in their car seats (p=0.08). All events were self-limited except for one PT infant, who required stimulation and was subsequently admitted to the NICU. No controls had apnea or bradycardia. Five infants (2 PT and 3 T) spent >25% of the time in the car seat with oxygen saturations < 90%. Both PT and T infants experienced a decrease in oxygen saturation in their car seats (TABLE).

O2 Saturations %time at sat value BASELINE %time at sat value CAR SEAT p-value
95-100% 79.5 54 0.0004
90-94% 20.5 36.5 0.0099
85-89% 0 9 0.013
<85% 0 0.5 0.018

Conclusions: Preliminary data suggests that even healthy, PT infants are at risk for respiratory instability in their car seats. However, both PT and T infants are equally susceptible to decreased oxygen saturations in their car seats.

OF-99-024

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