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Related Experiment Video

Updated: Mar 23, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
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VR-guided deep breathing during needle procedures in children.

Elina Karppa1,2,3, Kaija Puura4,5, Ilmari Jyskä6

  • 1TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, Elämänaukio 2, 33521, Tampere, Finland. elina.karppa@tuni.fi.

Scientific Reports
|March 22, 2026
PubMed
Summary
This summary is machine-generated.

Virtual reality (VR) deep breathing exercises effectively reduced children's stress and fear during needle procedures. This VR intervention significantly enhanced parasympathetic nervous system activity, indicating a calming effect.

Keywords:
Autonomic nervous systemChild patientDeep breathingFear of needlesHeart rate variabilityVirtual reality

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Area of Science:

  • Pediatric medicine
  • Psychophysiology
  • Virtual Reality applications

Background:

  • Virtual reality (VR) shows promise in reducing pediatric procedural anxiety.
  • However, its impact on the autonomic nervous system (ANS) and heart rate variability (HRV) during needle procedures requires further investigation.

Purpose of the Study:

  • To assess the feasibility and effectiveness of VR-mediated deep breathing exercises in managing pediatric stress and fear during venipuncture.
  • To evaluate the effects of this intervention on ANS activity using HRV measurements.

Main Methods:

  • A feasibility study involving 45 children undergoing venipuncture.
  • Comparison between a VR group performing 6-minute deep breathing exercises in a virtual natural environment and a control group receiving standard care.
  • Assessment of stress response via HRV measurements, including respiratory rate and high-frequency normalized units (HFnu).

Main Results:

  • The VR deep breathing group exhibited a significantly lower median respiratory rate (14 vs. 20, p < .001), indicating good compliance.
  • HRV measurements showed significantly greater parasympathetic nervous system activation (mean HFnu 61.57 vs. 40.46, p < .001) in the VR group compared to the control group.
  • The intervention was deemed feasible for managing procedural stress and fear.

Conclusions:

  • Virtual reality-mediated guided deep breathing is a viable non-pharmacological option for alleviating stress and fear in children during needle procedures.
  • This VR approach positively influences the autonomic nervous system, promoting relaxation.