Pain Behavioural Response to Acoustic and Light Environmental Changes in Very Preterm Infants
Audrey Marchal1, Meggane Melchior2, André Dufour3
1Service de Médecine et Réanimation du Nouveau-né, Hôpital de Hautepierre, Centre Hospitalier Universitaire de Strasbourg, 67000 Strasbourg, France.
Insights
Very preterm infants in the NICU show pain behaviors in response to sound peaks (SPs) and light level variations (LLVs). These environmental stressors, particularly noise, impact infant well-being and necessitate NICU sensory environment optimization.
Area of Science:
- Neonatal care
- Infant neurodevelopment
- Environmental medicine
Background:
- Neonatal intensive care units (NICUs) present sensory challenges like noise and light.
- These environmental factors are recognized stressors for vulnerable preterm infants.
- Understanding infant responses is crucial for developmental well-being.
Purpose of the Study:
- To evaluate pain behaviors in very preterm infants (VPIs) exposed to sound peaks (SPs) and light level variations (LLVs) in the NICU.
- To quantify the impact of these environmental stimuli on infant pain responses.
- To inform strategies for optimizing the NICU sensory environment.
Main Methods:
- Prospective observational study of 26 VPIs over 10 hours.
- Measurement of spontaneous SPs and LLVs within incubators.
- Analysis of infant behavioral responses using the "Douleur Aigue du Nouveau-né" (DAN) scale via video recordings.
Main Results:
- A total of 591 SPs and 278 LLVs were analyzed.
- SPs (5-15 dBA) and LLVs significantly increased DAN pain scores compared to baseline.
- 16% of SPs and 8% of LLVs elicited quantifiable pain behaviors (DAN score ≥ 3).
Conclusions:
- Very preterm infants exhibit sensitivity to both sound and light variations in the NICU.
- Infants showed a slightly higher sensitivity to sound peaks compared to light variations.
- Further research into the neurodevelopmental impact of these stimuli is warranted; NICU environments should be adapted for VPIs.
Abstract:
Noise and high light illumination in the neonatal intensive care unit (NICU) are recognized as stressors that could alter the well-being and development of vulnerable preterm infants. This prospective observational study evaluated the pain behaviours of very preterm infants (VPIs) to sound peaks (SPs) and light levels variations (LLVs) in the NICU. We measured spontaneously occurring SPs and LLVs in the incubators of 26 VPIs over 10 h. Their behavioural responses were analysed through video recordings using the "Douleur Aigue du Nouveau-né" (DAN) scale. We compared the maximum DAN scores before and after environmental stimuli and the percentage of VPIs with a score ≥ 3 according to the type of stimuli. A total of 591 SPs and 278 LLVs were analysed. SPs of 5 to 15 dBA and LLVs significantly increased the maximum DAN scores compared to baseline. The occurrence of DAN scores ≥ 3 increased with both stressors, with a total of 16% of SPs and 8% of LLVs leading to quantifiable pain behaviour. Altogether, this study shows that VPIs are sensitive to SPs and LLVs, with a slighter higher sensitivity to SPs. The mechanisms leading to pain behaviours induced by noise and light changes should be evaluated further in the context of VPIs brain development. Our results provide further arguments to optimize the NICU sensory environment of neonatal units and to adapt it to the expectations and sensory abilities of VPIs.
