Abstract
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 (≤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 3.1 ± 0.5 kg. Two patients were born at less than 37 weeks gestation. Surgical procedures included modified Blalock–Taussig shunt technique (n = 15), arterial switch operation (n = 12), Norwood Sano modification (n = 11), coarctation repair (n = 8), repair of tetralogy of Fallot (n = 6), repair of truncus arteriosus (n = 4), repair of total anomalous pulmonary venous return (n = 3), pacemaker placement (n = 2), repair of interrupted aortic arch and ventriculoseptal defect (VSD) (n = 1), repair of coarctation and VSD (n = 1), orthotopic heart transplant (n = 1), repair of VSD (n = 1), and patent ductus arteriosus ligation (n = 1). The average age at discharge was 28 ± 21 days. Four patients (6%) failed car safety seat testing because of a fall in oxygen saturation. One of the four patients passed on retesting after parental education, whereas three of the four (75%) were discharged home in a supine car safety seat. There was no relationship between the type of surgery and car safety seat test failure.
Conclusion
It may be beneficial to extend the AAP recommendations for car safety seat testing to include high-risk infants after cardiac surgery.
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References
Bass JL, Mehta KA, Camara J (1993) Monitoring premature infants in car seats: Implementing the American Academy of Pediatrics policy in a community hospital. Pediatrics 91:1137–1141
Committee on Injury, Poison Prevention, American Academy of Pediatrics (1999) Safe transportation of newborns at hospital discharge. Pediatrics 104:986–987
Limperopoulos C, Majnemer A, Shevell MI, Rosenblatt B, Rohlicek C, Tchervenkov C (1999) Neurologic status of newborns with congenital heart defects before open hart surgery. Pediatrics 103:402–408
Merchant JR, Worwa C, Porter S, Coleman JM, deRegnier RA (2001) Respiratory instability of term and near-term healthy newborn infants in car safety seats. Pediatrics 108:647–652
Miller G, Eggli KD, Contant C, Baylen BG, Myers JL (1995) Postoperative neurologic complications after open heart surgery on young infants. Arch Pediatr Adolesc Med 149:764–768
Veereman-Wauters G, Bochner A, Van Caillie-Bertrand M (1991) Gastroesophageal reflux in infants with a history of near-miss sudden infant death. J Pediatr Gastroenterol Nutr 12:319–323
Willett LD, Leuschen MP, Nelson LS, Nelson RM (1986) Risk of hypoventilation in premature infants in car seats. J Pediatr 109:245–248
Willett LD, Leuschen MP, Nelson LS, Nelson RM (1989) Ventilatory changes in convalescent infants positioned in car seats. J Pediatr 115:451–455
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Simsic, J.M., Masterson, K., Kogon, B.E. et al. Prehospital Discharge Car Safety Seat Testing of Infants After Congenital Heart Surgery. Pediatr Cardiol 29, 142–145 (2008). https://doi.org/10.1007/s00246-007-9065-3
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DOI: https://doi.org/10.1007/s00246-007-9065-3