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Pain and preterm infant

Timothy Disher, Britney Benoit, Celeste Johnston, Marsha Campbell-Yeo
AIMS: To assess the acceptability of methods that increase trial inclusion in meta-analyses, and the level of evidence for skin-to-skin contact for procedural pain in infants. BACKGROUND: The current Cochrane review of skin-to-skin contact for pain in newborns found it to be an effective intervention, but identified several methodological limitations. DESIGN: Meta-re-analysis. METHODS: Trial designs included randomized trials reporting a validated pain assessment tool as a primary outcome including term and preterm infants undergoing a tissue-breaking painful procedure...
October 12, 2016: Journal of Advanced Nursing
Welcy Cassiano de Oliveira Tobinaga, Cirlene de Lima Marinho, Vera Lucia Barros Abelenda, Paula Morisco de Sá, Agnaldo José Lopes
Background. In the neonatal intensive care unit (NICU) environment, preterm newborns are subject to environmental stress and numerous painful interventions. It is known that hydrokinesiotherapy promotes comfort and reduces stress because of the physiological properties of water. Objective. To evaluate the short-term effects of hydrokinesiotherapy on reducing stress in preterm newborns admitted to the NICU. Materials and Methods. Fifteen preterm newborns underwent salivary cortisol measurement, pain evaluation using the Neonatal Infant Pain Scale (NIPS), and heart rate, respiratory rate, and peripheral oxygen saturation measurements before and after the application of hydrokinesiotherapy...
2016: Rehabilitation Research and Practice
Xavier Durrmeyer, Claire Scholer-Lascourrèges, Laurence Boujenah, Pierre Bétrémieux, Olivier Claris, Micheline Garel, Monique Kaminski, Laurence Foix-L'Helias, Laurence Caeymaex
OBJECTIVE: Many extremely preterm neonates die in the delivery room (DR) after decisions to withhold or withdraw life-sustaining treatments or after failed resuscitation. Specific palliative care is then recommended but sparse data exist about the actual management of these dying babies. The objective of this study was to describe the clinical course and management of neonates born between 22 and 26 weeks of gestation who died in the DR in France. DESIGN, SETTING, PATIENTS: Prospective study including neonates, who were liveborn between 22(+0) and 26(+6) weeks of gestation and died in the DR in 2011, among infants included in the EPIPAGE-2 study at the 18 centres participating in this substudy of extremely preterm neonates...
August 16, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Tiffany Field
In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e...
August 2016: Complementary Therapies in Clinical Practice
Rosario Montirosso, Lorenzo Giusti, Alberto Del Prete, Rinaldo Zanini, Roberto Bellù, Renato Borgatti
BACKGROUNDPreterm birth and NICU stay are early adverse experiences, which may affect health-related quality of life (HRQoL) even in absence of prematurity-related morbidities. The aim of this multicenter longitudinal study was to examine the relation between quality levels of NICU Developmental Care (DC) and HRQoL at 60 months in children who were born preterm.METHODSHRQoL of 102 very preterm (VPT) children from 20 NICUs and 110 full-term controls was assessed using TNO-AZL Preschool Children's Quality of Life Questionnaire (TAPQOL)...
August 4, 2016: Pediatric Research
Jordana A Waxman, Rebecca R Pillai Riddell, Paula Tablon, Louis A Schmidt, Angelina Pinhasov
Background. Cardiovascular indices of pain are pervasive in the hospital setting. However, no prospective research has examined the development of cardiac responses to acutely painful procedures in the first year of life. Objectives. Our main goal was to synthesize existing evidence regarding the development of cardiovascular responses to acutely painful medical procedures over the first year of life in preterm and term born infants. Methods. A systematic search retrieved 6994 articles to review against inclusion criteria...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Sweta Kumari, Vikram Datta, Harmeet Rehan
AIM: To study the analgesic effect of oral 25% glucose as compared with oral 24% sucrose during heel lance in preterm neonates. METHODS: Stable preterm neonates within first 48 hours of life were randomized to receive either 24% sucrose or 25% glucose before heel lance. Primary outcome assessed was painful response by the Premature Infant Pain Profile (PIPP) score at 30 seconds after heel lance, and the secondary outcome was immediate adverse events associated with the administration of two solutions and duration of crying immediately following the procedure...
July 18, 2016: Journal of Tropical Pediatrics
Livio Provenzi, Lorenzo Giusti, Monica Fumagalli, Hilarj Tasca, Francesca Ciceri, Giorgia Menozzi, Fabio Mosca, Francesco Morandi, Renato Borgatti, Rosario Montirosso
Very preterm (VPT) infants are hospitalized in the Neonatal Intensive Care Unit (NICU) and exposed to varying levels of skin-breaking procedures (pain-related stress), even in absence of severe clinical conditions. Repeated and prolonged pain exposure may alter hypothalamic-pituitary-adrenal (HPA) axis reactivity in VPT infants. During the post-discharge period, altered HPA axis reactivity has been documented in response to non-social stressors, using salivary cortisol as a biomarker. However, little is known about the effects of NICU pain-related stress on subsequent HPA axis reactivity to socio-emotional stress in infants...
October 2016: Psychoneuroendocrinology
Katrine Rørbæk Knøsgaard, David John Richard Foster, Mads Kreilgaard, Eva Sverrisdóttir, Richard Neil Upton, Johannes N van den Anker
Morphine is commonly used for pain management in preterm neonates. The aims of this study were to compare published models of neonatal pharmacokinetics of morphine and its metabolites with a new dataset, and to combine the characteristics of the best predictive models to design a meta-model for morphine and its metabolites in preterm neonates. Moreover, the concentration-analgesia relationship for morphine in this clinical setting was also investigated. A population of 30 preterm neonates (gestational age: 23-32weeks) received a loading dose of morphine (50-100μg/kg), followed by a continuous infusion (5-10μg/kg/h) until analgesia was no longer required...
September 20, 2016: European Journal of Pharmaceutical Sciences
Dany Antanios Al Hamod, Smart Zeidan, Ayah Al Bizri, Georges Baaklini, Yolla Nassif
BACKGROUND: Among preterm infants, the peripherally inserted central catheter (PICC) is the standard line for central venous access; however, its placement exposes them to hypothermia and pain. Ultrasound (US)-guided central line insertion may be less morbid than standard PICC line. AIMS: To determine the ease, success rate, and morbidity associated with US-guided central line insertion in the internal jugular vein (IJV) by comparing it to the standard PICC line placement...
May 2016: North American Journal of Medical Sciences
A Milleret, C Bost-Bru, J Bustamante, C Durand, C Recule
Postvaccination osteo-articular mycobacterial infectious disease is a rare and potentially serious complication after Bacillus Calmette-Guérin (BCG) vaccine. We report on a case of a former preterm baby born at 30 weeks of gestation who was vaccinated with BCG Copenhagen strain at 2 months of age. He presented 6 months later with a painful limp, which was found to be a mono-articular osteitis of the right ankle. Histology of the biopsy showed signs of mycobacterial infection and molecular analysis confirmed a BCG infection...
July 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Tarja Pölkki, Anne Korhonen, Ulla Heikkinen, Anna-Kaija Palomaa, Seija Miettinen
UNLABELLED: Theme: Multidisciplinary team working. BACKGROUND: Pain assessment is unsystematic and only few nurses use pain scales in clinical practice. Poor compliance may indicate that scales are often inaccurate to assess specific behavior in vulnerable children. AIMS: The aim was to develop a feasible and sensitive enough pain assessment tool for neonates in close collaboration with clinical staff in the neonatal intensive care unit (NICU)...
May 9, 2016: Nursing Children and Young People
Kim Francis
BACKGROUND: Retinopathy of prematurity screenings is considered a painful procedure. Yet, preterm infants 30 weeks of gestation or less or weighing 1500 g or less or between 1500 and 2000 g or greater than 30 weeks of gestation with an unstable course are required to have these examinations until their eyes reach maturity. PURPOSE: A systematic search of the literature was conducted to answer the question "For premature infants undergoing retinal eye examinations, what interventions are the most effective for pain reduction?" METHODS/SEARCH STRATEGY: CINAHL Plus and MEDLINE were searched using the key words: retinopathy of prematurity and pain...
June 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Sean M Mooney-Leber, Susanne Brummelte
Advances in neonatal intensive care units (NICUs) have drastically increased the survival chances of preterm infants. However, preterm infants are still exposed to a wide range of stressors during their stay in the NICU, which include painful procedures and reduced maternal contact. The activation of the hypothalamic-pituitary-adrenal (HPA) axis, in response to these stressors during this critical period of brain development, has been associated with many acute and long-term adverse biobehavioral outcomes. Recent research has shown that Kangaroo care, a non-pharmacological analgesic based on increased skin-to-skin contact between the neonate and the mother, negates the adverse outcomes associated with neonatal pain and reduced maternal care, however the biological mechanism remains widely unknown...
May 7, 2016: Neuroscience
Britney Benoit, Marsha Campbell-Yeo, Celeste Johnston, Margot Latimer, Kim Caddell, Talia Orr
BACKGROUND: Skin-to-skin contact between mother and infant, commonly referred to as Kangaroo Care (KC), has demonstrated efficacy as a pain-relieving strategy for infants, yet, it remains underutilized in clinical practice. PURPOSE: To evaluate changes in neonatal intensive care unit staff nurse beliefs, utilization, and challenges related to practice change in implementing KC as an intervention for management of procedural pain in preterm infants between 2 time points...
June 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Julia Martini, Eva Asselmann, Franziska Einsle, Jens Strehle, Hans-Ulrich Wittchen
This study aimed to investigate the relation between anxiety disorders prior to pregnancy and specific pregnancy- and child-related fears during pregnancy and after delivery. 306 expectant mothers were interviewed regarding anxiety (and depressive) disorders prior to pregnancy and pregnancy- and child-related fears (e.g. fear of labor pain, fear of infant injury) using the Composite International Diagnostic Interview for Women (CIDI-V). Pregnancy- and child-related fears were particularly pronounced in women with multiple anxiety disorders and women with comorbid anxiety and depressive disorders prior to pregnancy...
May 2016: Journal of Anxiety Disorders
R Montirosso, L Giusti, A Del Prete, R Zanini, R Bellù, R Borgatti
OBJECTIVE: The aim of this study was to examine the relationship between the quality levels of NICU developmental care (DC) and language skills at 36 months in very preterm (VPT) children. STUDY DESIGN: Language skills of 78 VPT children from 19 NICUs and 90 full-term controls was assessed using a standardized language test. We compared children' language task performance by splitting NICUs into units with high- and low-quality of DC according to two main factors: (1) infant centered care (ICC), and (2) infant pain management (IPM)...
September 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Ann L Jefferies
Retinopathy of prematurity is a proliferative disorder of the developing retinal blood vessels in preterm infants. The present practice point reviews new information regarding screening and management for retinopathy of prematurity, including the role of risk factors in screening, optimal scheduling for screening examinations, pain management, digital retinal photography and antivascular endothelial growth factor therapy.
March 2016: Paediatrics & Child Health
Nai Ming Lai, Siew Cheng Foong, Wai Cheng Foong, Kenneth Tan
BACKGROUND: The increased birth rate of twins during recent decades and the improved prognosis of preterm infants have resulted in the need to explore measures that could optimize their growth and neurodevelopmental outcomes. It has been postulated that co-bedding simulates twins' intrauterine experiences in which co-regulatory behaviors between them are observed. These behaviors are proposed to benefit twins by reducing their stress, which may promote growth and development. However, in practice, uncertainty surrounds the benefit-risk profile of co-bedding...
2016: Cochrane Database of Systematic Reviews
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