title: Prehospital discharge car safety seat testing of infants after congenital heart surgery.
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 (< 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 3.1 +/- 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.
  
  
  CONCLUSIONS
  It may be beneficial to extend the AAP recommendations for car safety seat testing to include high-risk infants after cardiac surgery.
authors.affiliation: Sibley Heart Center Cardiology, 2835 Brandywine Road, Suite 300, Atlanta, GA 30341, USA. Simsicj@kidsheart.com
authors.forename: J M
authors.initials: JM
authors.lastname: Simsic
authors.forename: K
authors.initials: K
authors.lastname: Masterson
authors.forename: B E
authors.initials: BE
authors.lastname: Kogon
authors.forename: P M
authors.initials: PM
authors.lastname: Kirshbom
authors.forename: K
authors.initials: K
authors.lastname: Kanter
mesh_terms: D001049:Apnea / Q000209:etiology*; D001919:Bradycardia / Q000209:etiology*; D005774:Gastrostomy; D005865:Gestational Age; D017408:Guidelines as Topic; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000009:adverse effects* / Q000592:standards; D007231:Infant, Newborn; D007234:Infant, Premature; D007441:Intubation, Gastrointestinal; D008422:Materials Testing; D010100:Oxygen / Q000097:blood*; D010351:Patient Discharge; D012449:Safety; D016683:Supine Position / Q000502:physiology