The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial

Abstract Background Strong evidence suggests that maternal-infant skin-to-skin contact (SSC) is effective in reducing behavioural responses to pain. Given the multi-sensory benefits of SSC, it is highly likely that SSC provided during pain in early life may reduce pain-induced brain activity. The ai...

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Main Authors: Marsha Campbell-Yeo, Britney Benoit, Aaron Newman, Celeste Johnston, Tim Bardouille, Bonnie Stevens, Arlene Jiang
Format: Article
Language:English
Published: BMC 2022-06-01
Series:Trials
Subjects:
Online Access:https://doi.org/10.1186/s13063-022-06424-4
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author Marsha Campbell-Yeo
Britney Benoit
Aaron Newman
Celeste Johnston
Tim Bardouille
Bonnie Stevens
Arlene Jiang
author_facet Marsha Campbell-Yeo
Britney Benoit
Aaron Newman
Celeste Johnston
Tim Bardouille
Bonnie Stevens
Arlene Jiang
author_sort Marsha Campbell-Yeo
collection DOAJ
description Abstract Background Strong evidence suggests that maternal-infant skin-to-skin contact (SSC) is effective in reducing behavioural responses to pain. Given the multi-sensory benefits of SSC, it is highly likely that SSC provided during pain in early life may reduce pain-induced brain activity. The aim of this study is to examine the effect of SSC compared to 24% sucrose on pain-induced activity in the preterm infant brain during a medically required heel lance. Secondary objectives include determining (a) differences between behavioural pain response and noxious-related brain activity during heel lance and (b) rate of adverse events across groups. Methods We will randomly assign 126 babies (32 to 36 completed weeks gestational age) admitted to the neonatal intensive care unit, and their mothers within the first seven days of age to receive (i) SSC plus sterile water and (ii) 24% oral sucrose. Each baby will receive a medically indicated heel lance, following a no treatment baseline period. The primary outcome is noxious-related brain activity measured using an electroencephalogram (EEG) pain-specific event-related potential. Secondary outcomes include pain intensity measured using a bio-behavioural infant pain assessment tool (Premature Infant Pain Profile-Revised) and rate of adverse events. Discussion This will be the first clinical trial to compare the effect of SSC and 24% sucrose on pain-induced brain activity in the preterm infant brain during a clinical noxious stimulus, measured using EEG. Given the negative neurodevelopmental outcomes associated with unmanaged pain, it is imperative that preterm babies receive the most effective pain-reducing treatments to improve their health outcomes. Our findings will have important implications in informing optimal pain assessment and management in preterm infants. Trial registration ClinicalTrials.gov NCT03745963 . Registered on November 19, 2018.
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spelling doaj.art-f5037c11141c4f54bbb7b10ab20498e82022-12-22T00:30:30ZengBMCTrials1745-62152022-06-0123111310.1186/s13063-022-06424-4The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trialMarsha Campbell-Yeo0Britney Benoit1Aaron Newman2Celeste Johnston3Tim Bardouille4Bonnie Stevens5Arlene Jiang6School of Nursing, Faculty of Health, Dalhousie University and IWK HealthRankin School of Nursing, St. Francis Xavier UniversityFaculty of Science, Department of Psychology & Neuroscience, Dalhousie UniversityMcGill UniversityDepartment of Physics & Atmospheric Science, Dalhousie UniversityLawrence S Bloomberg Faculty of Nursing, University of Toronto and Child Health Evaluative Sciences Program, Research Institute, The Hospital for Sick Children (SickKids)Dalhousie UniversityAbstract Background Strong evidence suggests that maternal-infant skin-to-skin contact (SSC) is effective in reducing behavioural responses to pain. Given the multi-sensory benefits of SSC, it is highly likely that SSC provided during pain in early life may reduce pain-induced brain activity. The aim of this study is to examine the effect of SSC compared to 24% sucrose on pain-induced activity in the preterm infant brain during a medically required heel lance. Secondary objectives include determining (a) differences between behavioural pain response and noxious-related brain activity during heel lance and (b) rate of adverse events across groups. Methods We will randomly assign 126 babies (32 to 36 completed weeks gestational age) admitted to the neonatal intensive care unit, and their mothers within the first seven days of age to receive (i) SSC plus sterile water and (ii) 24% oral sucrose. Each baby will receive a medically indicated heel lance, following a no treatment baseline period. The primary outcome is noxious-related brain activity measured using an electroencephalogram (EEG) pain-specific event-related potential. Secondary outcomes include pain intensity measured using a bio-behavioural infant pain assessment tool (Premature Infant Pain Profile-Revised) and rate of adverse events. Discussion This will be the first clinical trial to compare the effect of SSC and 24% sucrose on pain-induced brain activity in the preterm infant brain during a clinical noxious stimulus, measured using EEG. Given the negative neurodevelopmental outcomes associated with unmanaged pain, it is imperative that preterm babies receive the most effective pain-reducing treatments to improve their health outcomes. Our findings will have important implications in informing optimal pain assessment and management in preterm infants. Trial registration ClinicalTrials.gov NCT03745963 . Registered on November 19, 2018.https://doi.org/10.1186/s13063-022-06424-4Infant/neonatePrematurityPainAcuteSkin-to-skin contactSweet taste
spellingShingle Marsha Campbell-Yeo
Britney Benoit
Aaron Newman
Celeste Johnston
Tim Bardouille
Bonnie Stevens
Arlene Jiang
The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial
Trials
Infant/neonate
Prematurity
Pain
Acute
Skin-to-skin contact
Sweet taste
title The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial
title_full The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial
title_fullStr The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial
title_full_unstemmed The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial
title_short The influence of skin-to-skin contact on Cortical Activity during Painful procedures in preterm infants in the neonatal intensive care unit (iCAP mini): study protocol for a randomized control trial
title_sort influence of skin to skin contact on cortical activity during painful procedures in preterm infants in the neonatal intensive care unit icap mini study protocol for a randomized control trial
topic Infant/neonate
Prematurity
Pain
Acute
Skin-to-skin contact
Sweet taste
url https://doi.org/10.1186/s13063-022-06424-4
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