Abstract
To explore the stability of the one-point Infant Car Seat Challenge and risk factors that may be associated with oxygen desaturation events. 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. 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. The findings indicated that 86% of premature infants had stable results, 8% passed Infant Car Seat Challenge 1 but not Infant Car Seat Challenge 2, and 6% failed Infant Car Seat Challenge 1 and passed Infant Car Seat Challenge 2. In addition, the odds for oxygen desaturation events increased for infants born at less than or equal to 34 weeks gestation and hospitalized longer than 7 days. The Infant Car Seat Challenge success rate for identifying infants at risk for oxygen desaturation events was equal to or better than that of other screening tests for newborn medical conditions. The findings of this study will assist neonatal health care providers in making appropriate recommendations for infants' safe travel at discharge.
Highlights
Since the early 1980s child safety seats (CSS; see Table 1) have played a major role in the safe travel of the youngest motor vehicle passengers in the U.S with the growing use of CSSs, researchers recognized that premature and low birthweight infants do not fit securely into some of the currently available models, thereby increasing the risk for injury (Bull & Stroup, 1985; Bull, Stroup, & Gerhardt, 1988a; Bull, Weber, & Stroup, 1988b)
Statement The purpose of this descriptive, non-experimental, and observational study was to explore the stability of the one-point Infant Car Seat Challenge (ICSC) by observing premature infants during a second ICSC and risk factors that may be associated with oxygen desaturation events
The specific aims of this study were to describe 1) the pass/fail rates of premature infants following two (ICSC) observation points, 2) oxygen saturation and desaturation patterns, sleep wake activity, and a measure of head lag for premature infants over the course of two ICSCs, and 3) the association between head lag, chronological age, time spent sleeping in the CSS and oxygen desaturation events experienced by premature infants during ICSCs
Summary
Since the early 1980s child safety seats (CSS; see Table 1) have played a major role in the safe travel of the youngest motor vehicle passengers in the U.S with the growing use of CSSs, researchers recognized that premature and low birthweight infants do not fit securely into some of the currently available models, thereby increasing the risk for injury (Bull & Stroup, 1985; Bull, Stroup, & Gerhardt, 1988a; Bull, Weber, & Stroup, 1988b). This chapter will present the theoretical framework for this study, based on Roy's Model of the Person as an Adaptive System (Roy, 1984; Roy & Andrews, 1999), and review the relevant literature on the infant car seat challenge (ICSC) and on risk factors for oxygen desaturation events of premature infants in a child safety seat prior to hospital discharge. Premature infants are not discharged from the hospital until they are apnea free (Eichenwald, Aina, & Stark, 1997; Martin & Fanaroff, 1998; Martin et al, 1986; Miller & Martin, 1998), infants who experienced oxygen desaturation events in their CSS were apnea free at the time of discharge These five important issues provide the rationale for examining the stability of the one-point ICSC and the associated risk factors for oxygen desaturation events
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