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Development of Cardiovascular Indices of Acute Pain Responding in Infants: A Systematic Review
Jordana A Waxman1, Rebecca R Pillai Riddell2, Paula Tablon1
1Department of Psychology, York University, Toronto, ON, Canada.
Insights
Infants show increased heart rate during painful procedures, but responses vary significantly with age. More research is needed to understand these cardiovascular pain responses in early life.
Area of Science:
- Neonatal pain research
- Cardiovascular physiology
- Infant development
Background:
- Cardiovascular indicators of pain are common in hospital settings.
- Prospective studies on cardiac responses to pain in infants are lacking.
- Understanding pain responses is crucial for infant care.
Purpose of the Study:
- To synthesize evidence on cardiovascular responses to painful procedures in infants.
- To examine developmental changes in these responses within the first year of life.
- To compare responses in preterm and term-born infants.
Main Methods:
- Systematic literature search yielding 6994 articles.
- Inclusion criteria applied to select relevant studies.
- Analysis of 41 studies on infant cardiovascular pain responses.
Main Results:
- Most infants exhibited increased mean heart rate (HR) during painful procedures.
- Magnitude of HR increase varied across and within gestational and postnatal ages.
- Heart rate variability research yielded inconsistent findings, limiting conclusions.
Conclusions:
- Longitudinal research is essential for a deeper understanding of cardiovascular pain responses.
- Further studies should investigate the variability of these responses across developmental ages.
- Identifying causes for variability in infant pain response is a key future direction.
Abstract:
Background. Cardiovascular indices of pain are pervasive in the hospital setting. However, no prospective research has examined the development of cardiac responses to acutely painful procedures in the first year of life. Objectives. Our main goal was to synthesize existing evidence regarding the development of cardiovascular responses to acutely painful medical procedures over the first year of life in preterm and term born infants. Methods. A systematic search retrieved 6994 articles to review against inclusion criteria. A total of 41 studies were included in the review. Results. In response to acutely painful procedures, most infants had an increase in mean heart rate (HR) that varied in magnitude both across and within gestational and postnatal ages. Research in the area of HR variability has been inconsistent, limiting conclusions. Conclusions. Longitudinal research is needed to further understand the inherent variability of cardiovascular pain responses across and within gestational and postnatal ages and the causes for the variability.
