title: Heart rate variability in response to pain stimulus in VLBW infants followed longitudinally during NICU stay.
abstract: The objective of this longitudinal study, conducted in a neonatal intensive care unit, was to characterize the response to pain of high-risk very low birth weight infants (<1,500 g) from 23 to 38 weeks post-menstrual age (PMA) by measuring heart rate variability (HRV). Heart period data were recorded before, during, and after a heel lanced or wrist venipunctured blood draw for routine clinical evaluation. Pain response to the blood draw procedure and age-related changes of HRV in low-frequency and high-frequency bands were modeled with linear mixed-effects models. HRV in both bands decreased during pain, followed by a recovery to near-baseline levels. Venipuncture and mechanical ventilation were factors that attenuated the HRV response to pain. HRV at the baseline increased with post-menstrual age but the growth rate of high-frequency power was reduced in mechanically ventilated infants. There was some evidence that low-frequency HRV response to pain improved with advancing PMA.
authors.affiliation: Center for Nursing Research The University of Texas School of Nursing at Houston, 6901 Bertner Avenue Ste. 560, P.O. Box 20334 Houston, TX 77225-0334, USA. nikhil.s.padhye@uth.tmc.edu
authors.forename: Nikhil S
authors.initials: NS
authors.lastname: Padhye
authors.forename: Amber L
authors.initials: AL
authors.lastname: Williams
authors.forename: Asif Z
authors.initials: AZ
authors.lastname: Khattak
authors.forename: Robert E
authors.initials: RE
authors.lastname: Lasky
mesh_terms: D000367:Age Factors; D001146:Arrhythmia, Sinus / Q000503:physiopathology*; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology*; D006365:Heel / Q000503:physiopathology; D006801:Humans; D018730:Infant Behavior / Q000502:physiology*; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D008137:Longitudinal Studies; D008297:Male; D008955:Models, Cardiovascular; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D012119:Respiration; D012815:Signal Processing, Computer-Assisted; D014741:Video Recording