Impact du cocooning et de la voix humaine sur le système nerveux autonome (SNA) de l’enfant grand prématuré

Resume Introduction L’inconfort, la douleur et le stress ont un impact defavorable sur le developpement psychomoteur de l’enfant premature. Des etudes recentes indiquent que la douleur et le stress sont associes a une reduction de l’activite parasympathique. Nous emettons l’hypothese que le cocooning associe a la voix humaine a un impact sur le tonus parasympathique chez l’enfant premature. Methode La variabilite de la frequence cardiaque (VFC) a ete comparee avant et apres des phases standardisees de cocooning associe a la voix humaine effectuees par la mere, d’une part, et par une tierce personne, d’autre part. L’indice de VFC etudie etait representatif du tonus parasympathique. Resultats Dix enfants ont ete inclus (âge gestationnel median = 33 semaines (extremes : 30 +4 –33 +2 ). Une augmentation de l’indice de VFC apres la periode du cocooning associe a la voix humaine comparee a la periode de base a ete observee, que l’intervention ait ete effectuee par la tierce personne ou par la mere ( p Conclusion Notre etude montre donc l’impact favorable du cocooning associe a la voix humaine sur le tonus parasympathique de l’enfant premature. Cependant, aucune difference significative n’a ete observee entre l’intervention de la mere et celle de la tierce personne. Ce resultat suggere que le cocooning associe a la voix humaine, qu’il soit realise par la mere ou par une tierce personne, a un effet favorable sur le confort de l’enfant premature.

[1]  L. Storme,et al.  Newborn Infant Pain Assessment Using Heart Rate Variability Analysis , 2010, The Clinical journal of pain.

[2]  L. Moyer-Mileur,et al.  The effect of massage on heart rate variability in preterm infants , 2013, Journal of Perinatology.

[3]  J. De Jonckheere,et al.  Validation of a graphic measurement of heart rate variability to assess analgesia/nociception balance during general anesthesia , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[4]  Giuseppe Mancia,et al.  Point: cardiovascular variability is/is not an index of autonomic control of circulation. , 2006, Journal of applied physiology.

[5]  Mircea Miclea,et al.  Reduced heart rate variability and vagal tone in anxiety: Trait versus state, and the effects of autogenic training , 2009, Autonomic Neuroscience.

[6]  A. Dassonneville,et al.  PhysioDoloris: a monitoring device for Analgesia / Nociception balance evaluation using Heart Rate Variability analysis , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[7]  J. Saul,et al.  Transfer function analysis of the circulation: unique insights into cardiovascular regulation. , 1991, The American journal of physiology.

[8]  Ruth E. Grunau,et al.  Biobehavioral Pain Responses in Former Extremely Low Birth Weight Infants at Four Months' Corrected Age , 2000, Pediatrics.

[9]  P. Fu,et al.  Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study. , 2009, Early human development.

[10]  A. Dassonneville,et al.  An efficient algorithm for R-R intervals series filtering , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[11]  M. Dehan,et al.  Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants , 2001, Archives of disease in childhood. Fetal and neonatal edition.

[12]  J. Saul,et al.  The Developmental Character of Cardiac Autonomic Responses to an Acute Noxious Event in 4- and 8-Month-Old Healthy Infants , 1998, Pediatric Research.

[13]  H. Prechtl,et al.  The behavioural states of the newborn infant (a review). , 1974, Brain research.

[14]  Régis Logier,et al.  Heart rate variability during total intravenous anesthesia: Effects of nociception and analgesia , 2009, Autonomic Neuroscience.

[15]  S. Ludington-Hoe,et al.  Heart rate variability responses of a preterm infant to kangaroo care. , 2005, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[16]  Vann Chau,et al.  Procedural pain and brain development in premature newborns , 2012, Annals of neurology.

[17]  E. Benarroch,et al.  Pain-autonomic interactions , 2006, Neurological Sciences.

[18]  D. Erik Everhart,et al.  Resting RSA is associated with natural and self-regulated responses to negative emotional stimuli , 2004, Brain and Cognition.

[19]  Yoshio Nakamura,et al.  Heart rate variability, trait anxiety, and perceived stress among physically fit men and women. , 2000, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[20]  R. Grunau,et al.  Neonatal pain, parenting stress and interaction, in relation to cognitive and motor development at 8 and 18months in preterm infants , 2009, Pain.

[21]  B. Appelhans,et al.  Heart rate variability and pain: Associations of two interrelated homeostatic processes , 2008, Biological Psychology.

[22]  Giuseppe Mancia,et al.  Point: Counterpoint: Cardiovascular variability is/is not an index of autonomic control of circulation , 2006 .

[23]  Régis Logier,et al.  Heart rate variability analysis for newborn infants prolonged pain assessment , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[24]  J. Taylor,et al.  Counterpoint: cardiovascular variability is not an index of autonomic control of the circulation. , 2006, Journal of applied physiology.