Evidence-Based Review of Oral Sucrose Administration to Decrease the Pain Response in Newborn Infants

2006 ◽  
Vol 25 (4) ◽  
pp. 275-284 ◽  
Author(s):  
Kathleen Leef
Keyword(s):  
Preterm Infants ◽  
Newborn Infants ◽  
Pain Response ◽  
Evidence Based ◽  
Invasive Procedures ◽  
Term Infants ◽  
Safety And Efficacy ◽  
Single Procedure ◽  
Repeated Doses ◽  
Oral Sucrose

Pain assessment and management are important issues for the neonatal nurse today. Clinicians have gradually come to acknowledge that newborn infants (term and preterm) are capable of responding to painful stimuli. This article reviews the evidence regarding the safety and efficacy of oral sucrose administration, to help answer the clinical question of how to manage an infant’s pain response to minor invasive procedures that are everyday occurrences in the NICU. This review included information on 1,077 infants enrolled in 16 studies. The evidence presented in the 16 studies reviewed here shows the safety and efficacy of sucrose in decreasing term infants’ pain response to a single procedure. In regard to preterm infants, there is insufficient evidence to recommend the use of sucrose as a routine comfort measure. More research is needed to determine the safety and efficacy of repeated doses of oral sucrose given for multiple procedures in preterm infants.

scholarly journals Delivery Room Management of Asphyxiated Term and Near-Term Infants

Neonatology ◽  
2021 ◽  
pp. 1-13
Author(s):  
Marlies Bruckner ◽  
Gianluca Lista ◽  
Ola D. Saugstad ◽  
Georg M. Schmölzer
Keyword(s):  
Preterm Infants ◽  
Newborn Infants ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Delivery Room ◽  
Temperature Management ◽  
Term Infants ◽  
Term Newborn ◽  
Resuscitation Guidelines ◽  
Delivery Room Management

Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants.

Vaccinations in Infants Born Preterm: An Update

2020 ◽  
Vol 16 (2) ◽  
pp. 148-155
Author(s):  
Areti Aphrodite Sioriki ◽  
Despoina Gkentzi ◽  
Evangelia Papadimitriou ◽  
Gabriel Dimitriou ◽  
Ageliki Karatza
Keyword(s):  
Preterm Infants ◽  
Vaccine Safety ◽  
Full Term ◽  
Morbidity And Mortality ◽  
Term Infants ◽  
Safety And Efficacy ◽  
Vaccine Preventable Diseases ◽  
Increased Risk ◽  
Protective Antibodies

Infants born prematurely (before completion of 37 weeks of gestation) are at increased risk of morbidity and mortality due to vaccine preventable diseases, mostly because of their immunological immaturity and failure of transfer of maternal protective antibodies. Despite their great need of being vaccinated, concerns on vaccine safety and efficacy, constitute the main reasons for which vaccinations are often delayed in this group. In this review we summarize the latest evidence on vaccine safety, efficacy and immunogenicity in preterm infants which is similar to full-term infants. Therefore there is no reason for delaying vaccination in this population.

Sucrose Analgesia for Minor Procedures in Newborn Infants

2001 ◽  
Vol 35 (7-8) ◽  
pp. 947-952 ◽  
Author(s):  
Lory D Masters-Harte ◽  
Susan M Abdel-Rahman
Keyword(s):  
Sucrose Solution ◽  
Newborn Infants ◽  
Pain Scale ◽  
Pain Response ◽  
Extensive Review ◽  
Invasive Procedures ◽  
Data Synthesis ◽  
Lower Pain ◽  
Effective Analgesia

OBJECTIVE: T o evaluate the role of intraoral sucrose and other sweet-tasting solutions for the management of pain associated with minor procedures in newborns. DATA SOURCES: A search of MEDLINE articles from 1966 to August 1999 and an extensive review of journals was conducted. MeSH headings included analgesia, sucrose, and neonate. DATA SYNTHESIS: Newborn infants regularly undergo minor invasive procedures for which analgesics are not routinely used. Intraoral sucrose and other sweet-tasting solutions appear to diminish surrogate biomarkers of pain response as evidenced by a reduction in crying time, smaller increases in heart rate, and lower pain scale ratings. CONCLUSIONS: These studies appear to suggest that sucrose solution 0.5 g provides effective analgesia with no reported adverse effects.

FREQUENCY AND IMPLICATIONS OF SEVERE NEONATAL PROTEIN C DEFICIENCY

1987 ◽  
Author(s):  
M J Manco-Johnson ◽  
T C Abshire ◽  
L J Jacobson
Keyword(s):  
Preterm Infants ◽  
Protein C ◽  
Newborn Infants ◽  
Postnatal Life ◽  
Protein C Deficiency ◽  
Term Infants ◽  
Severe Respiratory Distress ◽  
Thrombotic Risk ◽  
Thrombin Activation ◽  
Low Levels

The newborn infant has a physiologically low level of protein C which rises very slowly in postnatal life. The frequency and significance of severe neonatal protein C deficiency has not been reported. In this study, protein C levels were measured in 110 newborn infants at the time of birth using functional (amidolytic, Cact) and immunologic (Laurell rocket, Cag) assays. The protein C levels were compared with a marker of thrombin activation (D-dimer fragment of fibrin, +D-D) and infants were subsequently followed for signs and symptoms of thrombosis. Results are summarized below (protein C levels are expressed as U/ml).Thirteen infants had protein C levels compatible with the homozygous deficiency state. Extremely low levels of protein C (<0.20 U/ml) were not found in well term infants and were rarely noted in stable preterm infants. D-D were infrequently present and no thrombosis occurred. Near term infants born with fetal distress frequently showed +D-D but rarely demonstrated extremely low levels of protein C. None of these infants required indwelling arterial catheters and no thromboses occurred. Preterm infants with severe respiratory distress showed lower protein C levels at birth (p <0.01). Although 71% had +D-D, thromboses in these infants were all related to invasive catheterizations. In contrast, the study population of twins demonstrated a high frequency of severe protein C deficiency with negative D-D and frequent thromboses, three of which occurred in the absence of instrumentation. In summary, severe protein C deficiency and thrombin activation are common in sick preterm infants with the risk of thrombosis increased by intravascular catheterization. In contrast, twins with severe protein C deficiency may manifest a thrombotic risk which is independent of thrombin activation or catheterization.

Acoustic Examination of Preterm and Full-Term Infant Cries

1999 ◽  
Vol 42 (4) ◽  
pp. 850-861 ◽  
Author(s):  
Alexander M. Goberman ◽  
Michael P. Robb
Keyword(s):  
Preterm Infants ◽  
Newborn Infants ◽  
Term Infant ◽  
Speech Development ◽  
Full Term ◽  
Spectral Energy ◽  
Term Infants ◽  
Average Spectrum ◽  
Long Time ◽  
Infant Cries

The acoustic characteristics of crying behavior displayed in 2 groups of newborn infants are reported. The crying episodes of 10 full-term and 10 preterm infants were audio recorded and analyzed with regard to the long-time average spectrum (LTAS) characteristics. An LTAS display was created for each infant's non-partitioned crying episode, as well as for 3 equidurational partitions of the crying episode. Measures of first spectral peak, mean spectral energy, and spectral tilt were revealing of differences between full-term and preterm infants' non-partitioned crying episodes. In addition, the full-term infants demonstrated significant changes in their crying behavior across partitions, whereas the preterm infants changed little across the crying episode. Discussion focuses on possible differences between full-term and preterm infants in their neurophysiological maturity, and the subsequent impact on their speech development. The importance of examining entire crying episodes when evaluating the crying behavior of infants is also discussed.

Behavioral arousal in newborn infants and its association with termination of apnea

1991 ◽  
Vol 70 (6) ◽  
pp. 2479-2484 ◽  
Author(s):  
C. K. Thoppil ◽  
M. A. Belan ◽  
C. P. Cowen ◽  
O. P. Mathew
Keyword(s):  
Preterm Infants ◽  
Newborn Infants ◽  
Full Term ◽  
Protective Mechanism ◽  
Behavioral Arousal ◽  
Term Infants ◽  
Obstructive Sleep ◽  
Adults And Children ◽  
Polygraphic Recording ◽  
Arousal Rate

Arousal is an important protective mechanism that aids in the resolution of obstructive sleep apnea in adults and children, but its role in neonatal apnea has not been investigated. The primary aim of the present study was to determine the role of arousal in the termination of apnea in preterm infants. Videorecording was used to identify spontaneous behavioral arousal in a group of healthy full-term (n = 7) and preterm (n = 10) infants before and during polygraphic monitoring of cardiorespiratory variables and in a group of preterm infants with apnea (n = 10) during similar polygraphic monitoring. Spontaneous arousal rates (mean +/- SE) in full-term infants before and during polygraphic monitoring were 0.18 +/- 0.03 and 0.23 +/- 0.07 episodes/min, respectively. Corresponding values in nonapneic preterm infants were 0.24 +/- 0.03 and 0.24 +/- 0.02 episodes/min. In apneic preterm infants, mean spontaneous arousal rate during polygraphic recording was 0.26 +/- 0.02, but it was considerably higher during apneic sleep periods (0.59 +/- 0.17) than during nonapneic sleep periods (0.25 +/- 0.01). The frequency of occurrence of arousal was significantly higher (P less than 0.005) in long vs. short apnea, mixed vs. central apnea, and severe vs. mild apnea. Although a clear association between arousal and apneic resolution was observed in preterm infants, lack of arousal responses in a large number of apneic episodes suggests that behavioral arousal is not essential for the termination of apnea in these infants.

Effect of Prematurity on the Presence of Weibel-Palade Bodies in Human Umbilical Vein Endothelial Cell In Situ

1998 ◽  
Vol 4 (S2) ◽  
pp. 1164-1165
Author(s):  
N Tabatabaei ◽  
KH Albertine ◽  
L Wenhua ◽  
DE Lorant
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Preterm Infants ◽  
Premature Infants ◽  
Umbilical Vein ◽  
Newborn Infants ◽  
Human Umbilical Cord ◽  
Adult Rats ◽  
Term Infants

Newborn, premature infants have greater susceptibility to infection compared to older newborn infants. Although the reason for greater susceptibility to bacterial infection in premature infants is unknown, there are many reports that focus on polymorphonuclear leukocytes (neutrophils) as the defective cell type in the immature neonatal system. However, we have recently reported that in an rat model of inflammation, neutrophils from adult rats failed to migrate efficiently in neonatal rats. Furthermore, we found that this defect was associated with decreased expression of P-selectin on the surface of neonatal endothelial cells in situ. P-selectin is an adherence molecule that is expressed by activated endothelial cells and serves as the counterligand for CD11/CD18, the β2- integrin that is expressed by activated neutrophils.We hypothesized that endothelial cell P-selectin expression would be less in human umbilical cord veins from prematurely born (preterm) infants compared to normal term infants. To test this hypothesis, we collected umbilical cords from preterm infants (<27 weeks gestation) and term infants (>38 weeks gestation).

scholarly journals Study of Neuropeptide Substance P as A Marker of Pain in Newborn Infant

2021 ◽  
Vol 9 (B) ◽  
pp. 1615-1620
Author(s):  
Safaa ELMeneza ◽  
Iman ElBagoury ◽  
Enas Tawfik ◽  
Amel Tolba
Keyword(s):  
Substance P ◽  
Pain Score ◽  
Newborn Infant ◽  
Newborn Infants ◽  
Arm Movement ◽  
Full Term ◽  
Physiological Parameter ◽  
Invasive Procedures ◽  
Term Infants ◽  
Significant Difference

BACKGROUND: Prolonged and repeated untreated pain in newborn infant may produce a relatively permanent adverse long-term sequela. AIM: The aim of this study was to evaluate the potential role for neuropeptides substance P (SP) as neurochemical pain marker in newborn infants in order to decrease unnecessary use of analgesics and protect the developing brain. METHODS: This case-control study was conducted on 60 newborn infants. They were assigned to four groups, control preterm, sick preterm, control full term, and sick full term. All neonates were subjected to estimation of pain through neonatal infants pain score (NIPS) as well as Neuropeptide SP on the 1st and 5th day of life. The NIPS addresses five behavioral parameters (facial expression, crying, arm movement, leg movement, and state arousal) and one physiological parameter (breathing pattern). Results were further evaluated according to nature of the procedures; invasive and non-invasive procedures. RESULTS: There was a significant increase in the severity of pain score among the sick preterm and full-term infants after invasive procedures. There was a significant increase in SP in the sick preterm group than the control preterm on the 1st and 5th day of life; p were =0.003 and = 0.037, while full-term infants showed significant increase on the 5th day; p = 0.005. Furthermore, there was no significant difference in SP values between the preterm and full-term infants on the 1st and 5th day of life. SP increased significantly after invasive procedures than noninvasive procedures in the sick full-term and sick preterm infants weather in the 1st or 5th day of life. There was a significant correlation between the pain score NIPS and SP level on the 1st day of life. CONCLUSION: SP can be used as pain marker in sick preterm and full-term newborn infants. It showed increase with invasive procedures, acute and chronic pain.

Vaccinations in Infants Born Preterm: An Update

2020 ◽  
Vol 16 (2) ◽  
pp. 148-155
Author(s):  
Areti Aphrodite Sioriki ◽  
Despoina Gkentzi ◽  
Evangelia Papadimitriou ◽  
Gabriel Dimitriou ◽  
Ageliki Karatza
Keyword(s):  
Preterm Infants ◽  
Vaccine Safety ◽  
Full Term ◽  
Morbidity And Mortality ◽  
Term Infants ◽  
Safety And Efficacy ◽  
Vaccine Preventable Diseases ◽  
Increased Risk ◽  
Protective Antibodies

Infants born prematurely (before completion of 37 weeks of gestation) are at increased risk of morbidity and mortality due to vaccine preventable diseases, mostly because of their immunological immaturity and failure of transfer of maternal protective antibodies. Despite their great need of being vaccinated, concerns on vaccine safety and efficacy, constitute the main reasons for which vaccinations are often delayed in this group. In this review we summarize the latest evidence on vaccine safety, efficacy and immunogenicity in preterm infants which is similar to full-term infants. Therefore there is no reason for delaying vaccination in this population.

Measurement of the CO2 apneic threshold in newborn infants: possible relevance for periodic breathing and apnea

2005 ◽  
Vol 98 (4) ◽  
pp. 1171-1176 ◽  
Author(s):  
Akram Khan ◽  
Mansour Qurashi ◽  
Kim Kwiatkowski ◽  
Don Cates ◽  
Henrique Rigatto
Keyword(s):  
Control System ◽  
Confidence Interval ◽  
Preterm Infants ◽  
Newborn Infants ◽  
Respiratory Control ◽  
Periodic Breathing ◽  
Term Infants ◽  
Nonsignificant Increase ◽  
A Minor

We measured the Pco2 apneic threshold in preterm and term infants. We hypothesized that, compared with adult subjects, the Pco2 apneic threshold in neonates is very close to the eupneic Pco2, likely facilitating the appearance of periodic breathing and apnea. In contrast with adults, who need to be artificially hyperventilated to switch from regular to periodic breathing, neonates do this spontaneously. We therefore measured the apneic threshold as the average alveolar Pco2 (PaCO2) of the last three breaths of regular breathing preceding the first apnea of an epoch of periodic breathing. We also measured the PaCO2 of the first three breaths of regular breathing after the last apnea of the same periodic breathing epoch. In preterm infants, eupneic PaCO2 was 38.6 ± 1.4 Torr, the preperiodic PaCO2 apneic threshold was 37.3 ± 1.4 Torr, and the postperiodic PaCO2 was 37.2 ± 1.4 Torr. In term infants, the eupneic PaCO2 was 39.7 ± 1.1 Torr, the preperiodic PaCO2 apneic threshold was 38.7 ± 1.0 Torr, and the postperiodic value was 37.9 ± 1.2 Torr. This means that the PaCO2 apneic thresholds were 1.3 ± 0.1 and 1.0 ± 0.2 Torr below eupneic PaCO2 in preterm and term infants, respectively. The transition from eupneic PaCO2 to PaCO2 apneic threshold preceding periodic breathing was accompanied by a minor and nonsignificant increase in ventilation, primarily related to a slight increase in frequency. The findings suggest that neonates breathe very close to their Pco2 apneic threshold, the overall average eupneic Pco2 being only 1.15 ± 0.2 Torr (0.95–1.79, 95% confidence interval) above the apneic threshold. This value is much lower than that reported for adult subjects (3.5 ± 0.4 Torr). We speculate that this closeness of eupneic and apneic Pco2 thresholds confers great vulnerability to the respiratory control system in neonates, because minor oscillations in breathing may bring eupneic Pco2 below threshold, causing apnea.

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