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- Title
Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns.
- Authors
Olszewska, Marta; Pointinger-Tomasik, Stephanie; Kwinta, Przemko
- Abstract
The study aimed to evaluate the usefulness of salivary cortisol (SC) for the assessment of procedural pain intensity in preterm and term newborns. Three groups of neonates (term, 370–416 weeks; moderate to late preterm, 320–366; and very preterm, <320) hospitalized in neonatal intensive care unit were assessed for the study. Response to nappy change, lung ultrasound (LUS), and blood sampling was analyzed. The intensity of pain was evaluated using continuous heart rate and blood oxygen saturation (SpO2) monitoring, Neonatal Infant Pain Scale (NIPS), and SC concentrations. Saliva samples were collected before and 20 min after the procedure's end. Seventy-one infants were examined: 30 term, 21 moderate to late preterm, and 20 very preterm. SC has increased significantly in response to nappy change only in very preterm newborns (2.13 ng/mL [1.55–3.68] vs. 2.84 ng/mL [1.93–9.06], p = 0.01). LUS did not affect concentrations of SC in any group. Significant increase in SC was observed after blood sampling in term and very preterm infants (2.2 ng/mL [1.45–2.92] vs. 4.29 ng/mL [3.88–5.73], p = 0.002, and 1.88 ng/mL [1.47–4.13] vs. 5.3 ng/mL [3.42–8.02], p = 0.002, respectively). A significant correlation between values of SC increase and NIPS scores was found (Spearman's rank correlation coefficient [rs] = 0.31, p = 0.001). We observed the increase in SC concentrations in response to painful stimulus. The presence of a correlation between NIPS scores and SC increase suggests that SC can be used as an objective parameter to assess pain in neonates.
- Subjects
NEWBORN screening; BIOMARKERS; KRUSKAL-Wallis Test; STATISTICS; LENGTH of stay in hospitals; PAIN; NEONATAL intensive care; PAIN measurement; ACADEMIC medical centers; SALIVA; LUNGS; ONE-way analysis of variance; SURGICAL complications; NEONATAL intensive care units; BLOOD collection; HOSPITAL care of newborn infants; OXYGEN saturation; PATIENT monitoring; DIAPERS; HEART beat; DESCRIPTIVE statistics; CHI-squared test; PSYCHOPHYSIOLOGY; DATA analysis software; DATA analysis; FRIEDMAN test (Statistics); BRAIN injuries; RESPIRATORY distress syndrome; APGAR score; HYDROCORTISONE; RADIOIMMUNOASSAY; PAIN management; CHILDREN
- Publication
Journal of Perinatal Medicine, 2023, Vol 51, Issue 4, p564
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2022-0320