{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:19:05Z","timestamp":1787926745441,"version":"build-2784847793"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The AAP recommends that infants born &lt;37 weeks gestation or with risk factors for positional cardiorespiratory instability undergo a car seat tolerance screen (CSTS) before discharge. Understanding characteristics of CSTS failure may inform screening practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Compare clinical, oxygen saturation, and heart rate features in infants who failed vs. passed CSTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed CSTS data from a single level IV NICU (2018\u20132024). Clinical characteristics of infants who failed vs. passed their first CSTS were compared. For a subset with SpO\u2082 and HR data, we analyzed hypoxemia and bradycardia events the day before and during CSTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 2861 CSTSs from 2523 infants. First CSTS failure occurred in 111 infants (4.4%), most commonly due to oxygen desaturation in 85%. Of 111 infants who failed, 77% passed a second screen a mean of 1.9 days later, and overall length of stay was not significantly different based on CSTS result. Among 1136 infants with physiologic data, those who failed had more desaturation events the day before CSTS, and deeper and longer desaturations during the CSTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSTS failure was associated with more oxygen desaturations the day prior. Most infants passed a subsequent screen within a short time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This is the largest analysis of NICU car seat tolerance screens (CSTS) using continuous physiologic data.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Hypoxemia and bradycardia events occurred in some CSTS designated as \u201cpassed\u201d but events were deeper and longer in screens designated as \u201cfailed\u201d.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Infants that failed their first CSTS had lower mean SpO\n                            <jats:sub>2<\/jats:sub>\n                            and more desaturation events in the 24\u2009hours before the screen.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04524-w","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T16:34:15Z","timestamp":1761582855000},"page":"257-262","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Car seat tolerance screen failure in the neonatal intensive care unit: clinical, oxygen saturation and heart rate analysis"],"prefix":"10.1038","volume":"100","author":[{"given":"Britney","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Howard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Kausch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen D.","family":"Fairchild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"4524_CR1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.jpeds.2017.11.010","volume":"194","author":"EA Jensen","year":"2018","unstructured":"Jensen, E. A. et al. Car seat tolerance screening in the neonatal intensive care unit: failure rates, risk factors, and adverse outcomes. J. Pediatr. 194, 60\u201366.e1 (2018).","journal-title":"J. Pediatr."},{"key":"4524_CR2","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/j.acap.2013.01.009","volume":"13","author":"NL Davis","year":"2013","unstructured":"Davis, N. L., Zenchenko, Y., Lever, A. & Rhein, L. Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge. Acad. Pediatr. 13, 272\u2013277 (2013).","journal-title":"Acad. Pediatr."},{"key":"4524_CR3","doi-asserted-by":"publisher","first-page":"F136","DOI":"10.1136\/archdischild-2016-310730","volume":"102","author":"R Arya","year":"2017","unstructured":"Arya, R. et al. Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. Arch. Dis. Child Fetal Neonatal Ed. 102, F136\u2013F141 (2017).","journal-title":"Arch. Dis. 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