{"id":3995,"date":"2022-02-02T14:55:03","date_gmt":"2022-02-02T14:55:03","guid":{"rendered":"https:\/\/global.sentec.com\/schmerzen-auf-der-nicu\/"},"modified":"2022-02-02T14:55:28","modified_gmt":"2022-02-02T14:55:28","slug":"schmerzen-auf-der-nicu","status":"publish","type":"page","link":"https:\/\/global.sentec.com\/de\/schmerzen-auf-der-nicu\/","title":{"rendered":"Schmerzen auf der NICU"},"content":{"rendered":"

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Pain in the NICU<\/h1><\/div>

Patients in the NICU are among the most delicate residents in the hospital, yet studies have shown as many as 17 painful procedures being performed on neonates each day.1<\/sup> Many painful procedures are related to blood draws for lab tests used to monitor patients and titrate support. However, more frequent blood draws lead to increased instances of pain, which can result in both short- and long-term adverse outcomes for these fragile patients. It is essential to the quality of life and long-term outlook of these preterm infants that a comprehensive approach is taken to address pain in the NICU setting.<\/p>\n<\/div><\/div><\/div><\/div><\/div>

SCROLL<\/p>\n<\/div><\/i><\/div><\/div><\/div><\/div>

Neonates in the NICU may experience as many as 17 painful procedures<\/span> per day.1<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Neonates in the NICU may experience as many as 17 painful procedures<\/span> per day.1<\/sup><\/p>\n<\/div><\/div><\/div>

Average number of painful procedures performed in the NICU per day<\/em>.<\/h4><\/div>
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Of these painful procedures, heel sticks are the most common, comprising 61% to 87% of the invasive procedures<\/span> performed on ill infants.2<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Of these painful procedures, heel sticks are the most common, comprising 61% to 87% of the invasive procedures<\/span> performed on ill infants.2<\/sup><\/p>\n<\/div><\/div><\/div>

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Preterm infants are more sensitive to pain<\/span>, in part because they lack the neuro-development to comfort themselves.5<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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Preterm infants are more sensitive to pain<\/span>, in part because they lack the neuro-development to comfort themselves.5<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Analgesics are rarely given<\/span> for blood sampling, and few seem to be effective.2,6,7,8<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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Analgesics are rarely given<\/span> for blood sampling, and few seem to be effective.2,6,7,8<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

In addition to experiencing pain in the NICU, painful procedures in neonatal infancy may have short and long-term consequences, from increased blood pressure1<\/sup> to adverse neurological outcomes.9<\/sup><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>

In addition to experiencing pain in the NICU, painful procedures in neonatal infancy may have short and long-term consequences, from increased blood pressure1<\/sup> to adverse neurological outcomes.9<\/sup><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>

The short-term consequences of pain are well documented. An increase in HR, a decrease in SpO2<\/sub>, heart rate variability, blood pressure fluctuations and increased secretion of stress hormones<\/span> are noted in many studies.1<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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The short-term consequences of pain are well documented. An increase in HR, a decrease in SpO2<\/sub>, heart rate variability, blood pressure fluctuations and increased secretion of stress hormones<\/span> are noted in many studies.1<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Pain in the first few days<\/span> of life has been shown to magnify the pain response<\/span> to later stimuli.10<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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Pain in the first few days<\/span> of life has been shown to magnify the pain response<\/span> to later stimuli.10<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Long-term Outcomes Associated with Neonatal Pain: A Timeline<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>

Long-term Outcomes Associated with Neonatal Pain: A Timeline<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>

40 WEEKS<\/h4><\/div>

More early \u201cskin breaks\u201d were associated with:<\/p>\n

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  • reduced lateral thalamic volume<\/li>\n
  • slower metabolic thalamic growth<\/li>\n
  • altered\/reduced white matter microstructure11,12<\/sup><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
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    40 WEEKS<\/h4><\/div>

    More early \u201cskin breaks\u201d were associated with:<\/p>\n

      \n
    • reduced lateral thalamic volume<\/li>\n
    • slower metabolic thalamic growth<\/li>\n
    • altered\/reduced white matter microstructure11,12<\/sup><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>

      8-18 MONTHS<\/h4><\/div>

      Higher number of neonatal skin breaks predicted lower Mental Development Index13<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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      8-18 MONTHS<\/h4><\/div>

      Higher number of neonatal skin breaks predicted lower Mental Development Index13<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

      3 YEARS<\/h4><\/div>

      Cognitive and motor scores were predicted by thalamic volumetric growth, regardless of sex and GA at birth.11<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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      3 YEARS<\/h4><\/div>

      Cognitive and motor scores were predicted by thalamic volumetric growth, regardless of sex and GA at birth.11<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

      7 YEARS<\/h4><\/div>

      Cumulative neonatal pain-related stress was independently associated with changes in brain activity, which were negatively correlated with visual-perceptual abilities at school-age.9<\/sup><\/p>\n

      Greater number of invasive procedures were associated with reduced white matter and lower IQ14<\/sup><\/p>\n<\/div><\/div><\/div>

      8 YEARS<\/h4><\/div>

      More neonatal invasive procedures was associated with smaller amygdala and thalamus volumes, in turn related to poorer cognitive, visual-motor, and behavioral outcomes.15<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

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      7 YEARS<\/h4><\/div>

      Cumulative neonatal pain-related stress was independently associated with changes in brain activity, which were negatively correlated with visual-perceptual abilities at school-age.9<\/sup><\/p>\n

      Greater number of invasive procedures were associated with reduced white matter and lower IQ14<\/sup><\/p>\n<\/div><\/div><\/div>

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      8 YEARS<\/h4><\/div>

      More neonatal invasive procedures was associated with smaller amygdala and thalamus volumes, in turn related to poorer cognitive, visual-motor, and behavioral outcomes.15<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div>

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      Reducing painful procedures in the NICU is possible. Read the whitepaper. <\/span><\/p><\/h2><\/div>\n\t\t\t\t\t\t