Detection of Nociceptive Stimuli Using the Newborn Infant Parasympathetic Evaluation Index in Children Aged From 3 to 18 Years.

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Pediatric Anesthesia Pub Date : 2025-06-09 DOI:10.1111/pan.15129

Frantisek Kolek, Jakub Jonas, Tomas Vymazal

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引用次数: 0

Abstract

Background: One option to objectively monitor patient stress response is to measure parasympathetic nervous system tone using respiratory arrhythmia analysis. The Newborn Infant Parasympathetic Evaluation (NIPE) Index has been developed for children younger than 2 years of age, and reliability has been confirmed by several studies.

Aims: The aim of this study is to determine whether this method is also applicable to older children.

Methods: Patients aged 3-18 years, admitted to the Department of Anaesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, were included in this study. NIPE monitoring was provided on patients with airways secured by endotracheal intubation or tracheostomy. NIPE values were recorded before endotracheal suctioning, 1 min after the start, and 5 min after the end of suctioning. Subsequently, the averages of the values were analyzed using ANOVA and the Scheffé test. Along with the NIPE value, changes in hemodynamic parameters were monitored during the suction, and the results of both methods were compared.

Results: The NIPE value during endotracheal suctioning was significantly lower, with an average reduction of 13.4 points on a 100-point scale, and returned to baseline 5 min after suctioning ended. No significant changes in hemodynamic parameters (heart rate and blood pressure) were observed, either in the whole group of patients or in the group not receiving catecholamine support.

Conclusions: The NIPE index detects the stress response to endotracheal suctioning in children older than 3 years and is more sensitive than hemodynamic parameters, regardless of catecholamine therapy.

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用3 ~ 18岁新生儿副交感神经评价指数检测伤害性刺激。

背景：利用呼吸性心律失常分析测量副交感神经系统张力是客观监测患者应激反应的一种选择。新生儿副交感神经评价（NIPE）指数是针对2岁以下的儿童开发的，其可靠性已得到多项研究的证实。目的：本研究的目的是确定该方法是否也适用于年龄较大的儿童。方法：选取查尔斯大学第二医学院麻醉与重症医学部及布拉格Motol大学医院住院的3 ~ 18岁患者为研究对象。对气管插管或气管切开术固定气道的患者进行NIPE监测。分别记录气管吸痰前、吸痰开始后1分钟、吸痰结束后5分钟的NIPE值。随后，使用方差分析和scheff检验对这些值的平均值进行分析。结合NIPE值监测抽吸过程中血流动力学参数的变化，并比较两种方法的结果。结果：气管内吸痰时NIPE值明显降低，100分制平均降低13.4分，吸痰结束后5min恢复到基线水平。血流动力学参数（心率和血压）没有明显变化，无论是在整个组的患者或未接受儿茶酚胺支持的组。结论：无论儿茶酚胺治疗方式如何，NIPE指数检测3岁以上儿童气管内吸引的应激反应，比血流动力学参数更敏感。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Anesthesia 医学-麻醉学

CiteScore

3.20

自引率

11.80%

发文量

222

审稿时长

3-8 weeks

期刊介绍： Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.