Comparison of Respiratory Physiologic Features When Infants Are Placed in Car Safety Seats or Car Beds

The prolonged use of car safety seats by infants too young to sit unsupported may result in prolonged periods of oxygen desaturation. This article reports on a study undertaken to compare the respiratory physiologic features of healthy, full-term infants (n = 67) placed in either a car bed (n = 33) or a car safety seat (n = 34). During the study, the groups spent similar amounts of time in the devices (car bed: 71.6 minutes; car seat: 74.2 minutes). The mean oxygen saturation values were not different between the groups (car bed: 97.1%; car seat: 97.3%). The findings of percentages of time with oxygen saturation of less 95% were also similar for the 2 groups (car bed: 18.3%; car seat: 11.8%). In both groups, a number of infants spent high percentages of study time with oxygen saturation of less than 95%. The mean end-tidal carbon dioxide levels and the numbers of episodes of apnea were similar for the 2 groups. The authors note that substantial periods of time with oxygen saturation of <95% were surprisingly common in both groups. The authors review the limitations of the study but nonetheless conclude that additional refinements of the infant car seat and bed are necessary to minimize or prevent respiratory compromise in newborns. They recommend reduced use of these devices outside the setting of transportation in the car.