{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:07:58Z","timestamp":1791986878922,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Objective tools are needed to improve pain assessment in newborns. The aim of this study was to assess the correlation between the Newborn Infant Parasympathetic Evaluation (<jats:styled-content style=\"fixed-case\">NIPE<\/jats:styled-content>) index and two pain scales during a painful procedure in premature infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Each baby born at least at 26\u00a0weeks of gestational age (<jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>) undergoing a planned painful procedure in the Neonatal Intensive Care Unit (<jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content>) was eligible. <jats:styled-content style=\"fixed-case\">NIPE<\/jats:styled-content> index, heart rate variability (<jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content>) indices and Neonatal Acute Pain scale (<jats:styled-content style=\"fixed-case\">DAN<\/jats:styled-content>) were recorded across three periods: the first at rest 5\u00a0min before the painful procedure (T1), the second during it (T2) and the third 3\u00a0min after the end of it (T3). The Premature Infant Pain Profile\u2010Revised (<jats:styled-content style=\"fixed-case\">PIPP<\/jats:styled-content>\u2010R) pain scale was recorded at T2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010four recordings were performed in 29 preterm infants (mean <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>\u00a0=\u00a029.9\u00a0\u00b1\u00a04.2\u00a0weeks). Twenty\u2010eight tachograms were coupled to <jats:styled-content style=\"fixed-case\">NIPE<\/jats:styled-content> for analysis. We did not find a correlation between the <jats:styled-content style=\"fixed-case\">NIPE<\/jats:styled-content> index and <jats:styled-content style=\"fixed-case\">DAN<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PIPP<\/jats:styled-content>\u2010R at the pain time T2. Between T1 and T2, heart rate was higher (159\u00a0\u00b1\u00a016 vs. 169\u00a0\u00b1\u00a012, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Considering the linear <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> indices, we did not observe a modification in parasympathetic or sympathetic activity, while for the nonlinear <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> indices (H exponent, Approximate and conditional Entropy), a significant change towards a loss of physiological chaotic cardiac behaviour was detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">NIPE<\/jats:styled-content> index seems to be not reliable to assess acute pain in the preterm infant, but other <jats:styled-content style=\"fixed-case\">HRV<\/jats:styled-content> indices could be explored as additional tools next to pain scales in <jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">NIPE<\/jats:styled-content> monitor was developed for objective pain assessment in neonates based on <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>nu variations, but it does not seem reliable enough for assessing acute pain in real time in preterm neonates. Pain assessment in preterm babies still relies on pain scales.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1191","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T12:52:42Z","timestamp":1516884762000},"page":"1071-1079","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Objective assessment of induced acute pain in neonatology with the Newborn Infant Parasympathetic Evaluation index"],"prefix":"10.1002","volume":"22","author":[{"given":"C.","family":"Cremillieux","sequence":"first","affiliation":[{"name":"Department of Pediatric Medicine Neonatal Intensive Care Unit University Hospital of Saint\u2010Etienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Makhlouf","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine Neonatal Intensive Care Unit University Hospital of Saint\u2010Etienne 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