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NIPE – Parasympathetic Evaluation of the newborn child

It is estimated that human beings can feel pain starting 24 weeks of intrauterine life. There is a correlation between age and infant's pain reaction is: the youngest child, his reactions in response to a painful stimulus will increase. The same applies to repeated painful procedures - the intensity of pain response is proportional to the number of stimulations. In general, fear, anxiety or depression can increase our perception of pain. These factors may affect the newborn baby who does not always understand what is happening or may be expected from different experiences they had. This is true even when it comes to care based HDE, such as removing a simple bandage.
EPIPPAINE study, conducted in 2005-2006, showed that painful procedures are particularly frequent in an infant hospitalized. *From 430 children included, the study showed that there was an average of 17 invasive procedures a day for newborns and at least one procedure for newborns who were not ill (for example, taking samples blood).
NIPE technology offers an objective way to assess pain and discomfort in newborns.
To assess acute or prolonged pain, behavior rating scale are not always easy to apply. For example, EDIN scale (neonatal pain and discomfort scale) is used for prolonged pain assessment and analysis is based on parameters such as facial movements, quality of sleep and so on. This scale behavioral assessment must be performed by child support for a period of two hours, which is rarely observed in practice.
Bias parameter must be taken into account as well. The evaluator should be able to evaluate what he sees and what he feels there. Assessment scores for the same child will sometimes differ from one evaluator to another.
NIPE Monitor gives us an index based on an electrophysiological signal continuously and objectively assess or acute pain and patient comfort.
By using multiparameter monitor electrocardiogram provided, NIPE technology offers an objective assessment and continuous component of the parasympathetic autonomic nervous system of the newborn, both of extremely premature infants (26 weeks) until the age of two years. A high parasympathetic tone is correlated with the comfort and wellbeing.
Numerous experimental and clinical studies have shown that infants are particularly sensitive to stress. Any situation that causes pain or discomfort can alter neuronal development and can cause long-term consequences with increased risk of developing cardiovascular and metabolic diseases (hypertension, diabetes, obesity, cancer). There is also the possibility of cognitive influences that can lead to depression or an addiction or behavior of inadequate response to pain or stress. (Do HAD)



Why using NIPE technology

    • Non-invasive and continuous measurement
    • No additional sensors required and analysis in real time.

    • Easy to Read
    • A scale of 0 to 100 (the higher the index is highest shows confortabilitatea patient).
      Two indices: NIPEm (average) and nipples (instantaneous) correlation prolonged and acute pain respectively.

    • Evaluation of comfort and discomfort with NIPEm
    • To optimize environmental conditions: noise, light, position, choosing … CPAP mask (Kuissi 2009 JFRN – Rethore 2011 JFRN)
      Illustrates welfare arising from the development of care: presence of parents, cocooning, skin-to-skin contact (Alexandre 2013, Arch Pediatr – Blouin 2014 JFRN)

    • Evaluation of prolonged pain with NIPEm
    • In order to adapt analgesia for postoperative patients. (Faye 2010, Clin J Pain – De Jonckheere 2011 Conf Proc IEEE Eng Med Biol Soc – Rakza 2011 JFRN – Blouin 2014 JFRN)


NIPEm (average NIPE) is displayed in blue on the top right of the screen and the blue curve. This index refers to the general welfare of the newborn, as well as prolonged pain.
The objective is to keep the blue line above 50. Below this threshold, consider the patient a child is uncomfortable or in pain status. At the time, it is important to tailor treatment or to adapt to environmental conditions in order to move the curve back to your comfort zone.
NIPEi (instantly NIPE) is displayed as red spikes on the main screen of the nipples, it is used to assess acute pain during a procedure potentially painful or stressful. This diagram displays painful procedures in order to adjust care accordingly.
The interpretation is the same as for NIPEm: If the index is below 50, we conclude that the situation is painful or stressful for the patient.