Environment and Sleep on Preterm Infant Pain Response

描述（由申请人提供）：新生儿重症监护室的早产儿 护理单位（NICU）经常遭受必要但痛苦的诊断和治疗。 治疗程序。反复痛苦的手术的累积效应 对发育中的大脑可能具有更大的生物学和临床意义 比以前认识到的。新生儿疼痛研究主要集中在 行为和生理反应，通过研究健康，足月婴儿， 年龄较大的生理稳定的早产儿。声音之间的关系 NICU中的光照水平和早产儿的觉醒（睡眠和清醒） 模式）与其对疼痛的反应尚未进行研究。具体 本研究的目的是检查（a）声音（Lmax）和 光（英尺烛光）水平作为NICU中的环境变量，（B）唤醒 新生儿水平（睡眠和觉醒模式的Als状态评分），以及（c） 生理和行为反应（心率、氧饱和度、早产儿 早产儿疼痛特征（PIPP）评分）之前和之后， 疼痛刺激-必要的血液采样的脚跟。即时 对疼痛过程的反应和从过程中恢复的时间 （恢复至基线、术前生理和行为水平） 研究了这项研究还将探讨是否之间的关系， 声音、光线和唤醒水平在高跟鞋前2小时 程序和早产儿对疼痛的反应受到妊娠的影响。 年龄102名早产儿的便利样本（分层为两个相等的 胎龄组：25-27周和34-36周）将在 新生儿重症监护室疼痛的生理反应将使用婴儿的床边测量 心肺监护仪和脉搏血氧仪。声音和灯光水平将 分别使用声光计收集。生理和 环境数据将使用 计算机化数据采集系统将使用通用 线性模型（GLM）和分层回归分析。长期目标 本研究的目的是调查护理干预措施，（a）最大限度地减少 婴儿对疼痛的急性生理和行为反应，通过促进最佳 住院新生儿的NICU环境和唤醒（睡眠/觉醒）模式， (b)为了改善危重早产新生儿的疼痛评估技术， 和最终，（c）减少慢性， 重复的疼痛体验。

DESCRIPTION (provided by applicant): Preterm neonates in the Neonatal Intensive Care Unit (NICU) frequently suffer necessary but painful diagnostic and therapeutic procedures. The cumulative effects of repeated painful procedures on the developing brain may be of greater biological and clinical importance than previously recognized. Pain research in neonates has focused primarily on behavioral and physiologic responses by studying health, full-term infants, and older physiologically stable preterm infants. The relationship between sound and light levels in the NICU and preterm infants' arousal (sleep and wake patterns) with their responses to pain has not been investigated. The specific aims of this study are to examine the relationship between (a) sound (Lmax) and light (foot-candles) levels as environmental variables in the NICU, (b) arousal level of neonates (Als State Score for sleep and wake patterns), and (c) physiologic and behavioral responses (heart rate, oxygen saturation, Premature Infant Pain Profile (PIPP) score) of preterm infants prior to and following a painful stimulus - a heelstick for necessary blood sampling. Both immediate responses to the painful procedure and time to recover from the procedure (return to baseline, pre-procedure physiological and behavioral levels) will be studied. This research will also examine whether the relationships between sound, light, and arousal levels in the 2 hours preceding the heelstick procedure and preterm infants' responses to pain are moderated by gestational age. A convenience sample of 102 preterm infants (stratified into two equal gestational age groups: 25-27 weeks and 34-36 weeks) will be observed in the NICU. Physiologic responses to pain will be measured using the infant's bedside cardiorespiratory monitor and pulse oximeter. Sound and light levels will be collected using sound and light meters, respectively. Physiologic and environmental data will be collected, synchronized, and stored using a computerized data acquisition system. Data will be analyzed using general linear models (GLMs) and hierarchical regression analyses. The long-term aims of this research are to investigate nursing interventions that (a) minimize infant acute physiologic and behavioral responses to pain by promoting optimal NICU environment and arousal (sleep/wake) patterns for hospitalized neonates, (b) to improve pain assessment techniques in critically ill preterm neonates, and ultimately, (c) to decrease long-term neurobehavioral sequelae of chronic, repetitive pain experiences.