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Pain Research and Management
Volume 2016, Article ID 8458696, 15 pages
Review Article

Development of Cardiovascular Indices of Acute Pain Responding in Infants: A Systematic Review

1Department of Psychology, York University, Toronto, ON, Canada
2Hospital for Sick Children, Toronto, ON, Canada
3Department of Psychiatry, University of Toronto, Toronto, ON, Canada
4Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada

Received 18 August 2015; Accepted 20 August 2015

Copyright © 2016 Jordana A. Waxman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Cardiovascular indices of pain are pervasive in the hospital setting. However, no prospective research has examined the development of cardiac responses to acutely painful procedures in the first year of life. Objectives. Our main goal was to synthesize existing evidence regarding the development of cardiovascular responses to acutely painful medical procedures over the first year of life in preterm and term born infants. Methods. A systematic search retrieved 6994 articles to review against inclusion criteria. A total of 41 studies were included in the review. Results. In response to acutely painful procedures, most infants had an increase in mean heart rate (HR) that varied in magnitude both across and within gestational and postnatal ages. Research in the area of HR variability has been inconsistent, limiting conclusions. Conclusions. Longitudinal research is needed to further understand the inherent variability of cardiovascular pain responses across and within gestational and postnatal ages and the causes for the variability.