Epidemiology and neonatal pain management of heelsticks in intensive care units: EPIPPAIN 2, a prospective observational study

Courtois, Émilie; Droutman, S.; Magny, Jean‐François; Merchaoui, Zied; Durrmeyer, Xavier; Roussel, Camille; Biran, Valérie; Eleni, S; Vottier, G.; Renolleau, Sylvain; Desfrère, Luc; Castela, Florence; Boimond, N.; Mellah, D.; Bolot, Pascal; Coursol, Anne; Bron, Dominique; Chappuy, Hélène; Cimerman, Patricia; Anand, Kanwaljeet J. S.; Carbajal, Ricardo

doi:10.1016/j.ijnurstu.2016.03.014

Cited by 79 publications

(67 citation statements)

References 39 publications

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“…26-30 Recent multicenter studies in France also showed that a newborn experienced a mean number of 16 heelsticks and 4 venipunctures during a mean of 8 days NICU hospitalization without routine analgesic use. 31,32 The frequency of acute pain/stressors found in our study was higher than many previous studies; this may be due to different measurement tools being used in studies as well as the increased severity of illness and younger gestation of the infants participating in our study. The modified NISS instrument used in the study, included elements such as diaper change, position change, mouth care, bathing, and weighing (Fig.…”

Section: Discussioncontrasting

confidence: 69%

The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU

Cong

Vittner

et al. 2017

Early Human Development

155

130

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Background Vulnerable preterm infants experience repeated and prolonged pain/stress stimulation during a critical period in their development while in the neonatal intensive care unit (NICU). The contribution of cumulative pain/stressors to altered neurodevelopment remains unclear. The study purpose was to investigate the impact of early life painful/stressful experiences on neurobehavioral outcomes of preterm infants in the NICU. Methods A prospective exploratory study was conducted with fifty preterm infants (28 0/7 – 32 6/7 weeks gestational age) recruited at birth and followed for four weeks. Cumulative pain/stressors (NICU Infant Stressor Scale) were measured daily and neurodevelopmental outcomes (NICU Network Neurobehavioral Scale) were examined at 36-37 weeks post-menstrual age. Data analyses were conducted on the distribution of pain/stressors experienced over time and the linkages among pain/stressors and neurobehavioral outcomes. Results Preterm infants experienced a high degree of pain/stressors in the NICU, both in numbers of daily acute events (22.97±2.30 procedures) and cumulative times of chronic/stressful exposure (42.59±15.02 hours). Both acute and chronic pain/stress experienced during early life significantly contributed to the neurobehavioral outcomes, particularly in stress/abstinence (p < 0.05) and habituation responses (p < 0.01), meanwhile, direct breastfeeding and skin-to-skin holding were also significantly associated with habituation (p < 0.01 – 0.05). Conclusion Understanding mechanisms by which early life experience alters neurodevelopment will assist clinicians in developing targeted neuroprotective strategies and individualized interventions to improve infant developmental outcomes.

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Section: Discussioncontrasting

confidence: 69%

The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU

Cong

Vittner

et al. 2017

Early Human Development

155

130

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“…From the first hours to the first month of life, term and preterm infants undergo painful needle‐related procedures for newborn and jaundice screening, and other blood sampling. Studies conducted in developed and developing countries clearly demonstrate that procedural pain prevention and management in newborn infants is suboptimal across the globe and in most settings newborns do not receive appropriate analgesia (Carbajal et al., ; Courtois et al., ; Harrison, Loughnan, Manias, & Johnston, ; Johnston, Barrington, Taddio, Carbajal, & Filion, ; Kyololo, Stevens, Gastaldo, & Gisore, ; Roofthooft, Simons, Anand, Tibboel, & van Dijk, ; Stevens et al., ). For sick and preterm infants, the number of painful procedures is considered as a strong predictor of poor neurological outcomes (Brummelte et al., ; Doesburg et al., ; Vinall et al., ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a parent‐targeted video in Portuguese to improve pain management practices in neonates

Bueno

Costa

Camargo

et al. 2018

Journal of Clinical Nursing

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“…The two studies differed in that the parents were not encouraged to be present in the study by Kleberg et al., and this study showed considerably higher PIPP scores. Although a favourable effect of parental involvement appears to be supported by others , mechanisms of action and the relative importance of each intervention in a multidimensional approach are not known. Parental involvement in the pain management strategy seems to be important but might be challenged by organisational routines and the fact that parents must be able to be present in the NICU.…”

Section: Discussionmentioning

confidence: 99%

Skin‐to‐skin contact during eye examination did not reduce pain compared to standard care with parental support in preterm infants

et al. 2019

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Aim: We compared the pain relieving effect of skin-to-skin contact versus standard care in the incubator during screening for retinopathy of prematurity.Methods: This randomised crossover study included 35 preterm infants of less than 32 weeks of gestational age admitted to St Olavs University Hospital, Trondheim, Norway, between January 2014 and June 2016. Randomisation was for skin-to-skin with one of the parents or standard care with supportive positioning by parents for the first of two consecutive eye examinations. The pain score was measured twice using the Premature Infant Pain Profile (PIPP) during and after the eye examination. The infants' movement activity was video recorded after the examination.Results: There was no difference in mean pain scores with skin-to-skin contact versus standard care during (10.2 vs. 10.3, p = 0.91) or after (7.0 vs. 6.8, p = 0.76) the procedure. Independent of the randomisation group, PIPP scores were lower than previous comparable studies have found. Bouts of movement activity were also the same whether the examination was conducted in skin-to-skin position or in the incubator (p = 0.91).Conclusion: Skin-to-skin contact during the eye examination did not provide additional pain relief compared to standard care where the parents were already a part of the multidimensional approach.

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Epidemiology and neonatal pain management of heelsticks in intensive care units: EPIPPAIN 2, a prospective observational study

Cited by 79 publications

References 39 publications

The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU

The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU

Evaluation of a parent‐targeted video in Portuguese to improve pain management practices in neonates

Skin‐to‐skin contact during eye examination did not reduce pain compared to standard care with parental support in preterm infants

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