Faculty, Staff and Student Publications

Heart Rate Variability in Response to Pain Stimulus in VLBW Infants Followed Longitudinally During NICU Stay

Publication Date

12-1-2009

Journal

Developmental Psychobiology

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.

Keywords

pain, respiratory sinus arrhythmia, vagal tone, very low birth weight infants, spectral analysis, mechanical ventilation, growth curve, heel lance, venipuncture, frequency domain measures

DOI

10.1002/dev.20399

PMID

19739134

PMCID

PMC2936240

PubMedCentral® Posted Date

December 2010

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

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