Patients in the NICU are among the most delicate residents in the hospital, yet studies reveal that an average of 17 painful procedures is performed on neonates each day.1 Many of these procedures are blood draws used to monitor patients and titrate support. However, the pain associated with these tests carries both short- and long-term consequences that are important to consider. A comprehensive approach to pain in the NICU setting is essential to the quality of life and long-term outlook of these preterm infants.
How Often Are Preterm Infants Exposed to Pain?
NICU patients require extensive testing and frequent handling that can leave them distressed, exhausted, and in significant amounts of pain. It has been demonstrated that neonates may endure 12 or more daily painful procedures, with individual patients enduring as many as 51 painful procedures in one day.2
Heel punctures are responsible for 61-87% of invasive procedures performed on these infants3 and are mostly taken to evaluate blood gases and pH levels, which help clinicians titrate patient care and ventilatory support.
References
- Carroll, P.D., Widness, J.A. Nonpharmacological, blood conservation techniques for preventing neonatal anemia–effective and promising strategies for reducing transfusion. Semin Perinatol. 2012.
- Widness, J.A. Pathophysiology of Anemia During the Neonatal Period, Including Anemia of Prematurity. Neoreviews. 2008.
- Tilahun, D., et al. High Magnitude of Neonatal Anemia Among Sick Newborns Admitted to University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. J Blood Med. 2008.
- Whitehead, N.S., et al. Interventions to prevent iatrogenic anemia: a Laboravtory Medicine Best Practices systematic review. Crit Care. 2019.
- Gephart, S.M. Transfusion-associated necrotizing enterocolitis: evidence and uncertainty. Adv Neonatal Care. 2012.
- Hochwald, O., et al. Continuous Noninvasive Carbon Dioxide Monitoring in Neonates: From Theory to Standard of Care. Pediatrics. 2019.
- Alves-Dunkerson, J.A., et al. Cost analysis of a neonatal point-of-care monitor. Am J Clin Pathol. 2002.
- Counsilman, C.E., et al. Iatrogenic blood loss in extreme preterm infants due to frequent laboratory tests and procedures. J Matern Fetal Neonatal Med. 2021.
