Manon Ranger
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I am conducting novel translational research to advance the health and care of children and their families. Specifically, my long-term goal is to improve the care of infants born preterm (< 37 weeks gestation). To accomplish this, I am leading a research program to address the impact of early stress, such as pain, inflammation, clinical treatments and maternal separation, on the developing brain of very preterm infants, and to assure that these findings will be translated into clinical practice. Particularly, I aim to determine possible mechanisms underlying the effects of early stress, such as pain-related changes, and to test novel mitigating treatments in both animal models and in human infants. Indeed, in order to improve clinical care for preterm infants in the neonatal intensive care unit (NICU), much more research is needed to examine long-term effects of neonatal early exposure to stressful events and treatments on brain development and later outcomes, particularly in those born very preterm (< 32 weeks gestation); this work is necessary so that we can understand the etiology of neurodevelopmental problems which occur at high rates in these vulnerable children.
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No abstract available.
Background: In the neonatal intensive care unit, preterm infants experience 7-17 clinically required but painful procedures daily. Oral sucrose is the standard treatment for minor procedural pain, but the combined short-term cumulative effects of sucrose treatment for pain on brain development are unknown. Using a neonatal mouse paradigm, previous studies found that during the 1st week of life, repeated pain and/or sucrose exposure impaired short-term memory and reduced regional and white matter structure volumes in adulthood, including the corpus callosum, fimbria, and the hippocampus. The objective of this study was to determine whether repeated neonatal pain and/or sucrose exposure altered pro/anti-inflammatory markers, specifically IL-1β, IL-6, and TNF-α, in hippocampal tissue and serum of 8-day old mouse pups. Hippocampal microglial density of male mouse pups was also examined.Methodology: Using a previously established neonatal mouse paradigm, neonatal mice were randomly assigned to receive water or 24% oral sucrose prior to being handled or needle-pricked, 10X/day from postnatal day (P) 1-6. Blood and hippocampal tissue were collected at P8 and assayed for various cytokines (e.g. IL-1β, IL-6, and TNF-α). In addition to cytokine levels, microglial density was assessed in the hippocampus of P8 male mice.Results: Although no sex effects were evident, a significant group effect was found for several inflammatory cytokines. Hippocampal IL-10 levels were significantly lower in sucrose + handling (p
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Publications
- The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol [version 1; peer review: 2 approved] (2021)
- Adverse behavioral changes in adult mice following neonatal repeated exposure to pain and sucrose (2019)
Frontiers in Psychology, 9 (JAN) - Hippocampus, amygdala, and thalamus volumes in very preterm children at 8 years: Neonatal pain and genetic variation (2019)
Frontiers in Behavioral Neuroscience, 13 - Is near infrared spectroscopy valid for the detection of procedural pain in postoperative cardiac surgery intensive care unit adults? (2017)
Journal of Near Infrared Spectroscopy, 25 (6), 391-399 - Repeated exposure to sucrose for procedural pain in mouse pups leads to long-term widespread brain alterations (2017)
Pain, 158 (8), 1586-1598 - Neonatal Invasive Procedures Predict Pain Intensity at School Age in Children Born Very Preterm (2016)
Clinical Journal of Pain, 32 (12), 1086-1093 - How do babies feel pain? (2015)
eLife, 2015 (4), 1-3 - Neonatal Pain and Infection Relate to Smaller Cerebellum in Very Preterm Children at School Age (2015)
Journal of Pediatrics, 167 (2), 292-298.e1 - Early repetitive pain in preterm infants in relation to the developing brain (2014)
Pain management, 4 (1), 57-67 - Innovating in Pain Assessment of the Critically Ill: Exploring Cerebral Near-Infrared Spectroscopy as a Bedside Approach (2014)
Pain Management Nursing, 15 (2), 519-529 - Internalizing behaviours in school-age children born very preterm are predicted by neonatal pain and morphine exposure (2014)
European Journal of Pain (United Kingdom), 18 (6), 844-852 - Neonatal pain and comt Val158Met genotype in relation to serotonin transporter (SLC6A4) promoter methylation in very preterm children at school age (2014)
Frontiers in Behavioral Neuroscience, 8 (DEC) - A multidimensional approach to pain assessment in critically ill infants during a painful procedure (2013)
Clinical Journal of Pain, 29 (7), 613-620 - Neonatal Pain-Related Stress Predicts Cortical Thickness at Age 7 Years in Children Born Very Preterm (2013)
PLoS ONE, 8 (10) - Maternal Touch and Talk for Invasive Procedures in Infants and Toddlers in the Pediatric Intensive Care Unit (2012)
Journal of Pediatric Nursing, 27 (2), 144-153 - Cerebral near-infrared spectroscopy as a measure of nociceptive evoked activity in critically ill infants (2011)
Pain Research and Management, 16 (5), 331-336 - Incidence of self-limiting back pain in children following caudal blockade: An exploratory study (2010)
Paediatric Anaesthesia, 20 (9), 844-850 - Toward a new approach for the detection of pain in adult patients undergoing cardiac surgery: Near-infrared spectroscopy—A pilot study (2010)
Heart and Lung: Journal of Acute and Critical Care, 39 (6), 485-493 - An acute pain service improves postoperative pain management for children undergoing selective dorsal rhizotomy (2009)
Paediatric Anaesthesia, 19 (12), 1213-1219 - Controlling bias in complex nursing intervention studies: A checklist (2009)
Canadian Journal of Nursing Research, 41 (4), 32-50 - Developing synergy to enhance the impact of nursing intervention research on patient health (2009)
Canadian Journal of Nursing Research, 41 (4), 115-121 - Interventions used in Emergency Departments (ED) for pain management of simple fractures in children (2009)
Cochrane Database of Systematic Reviews, (1) - Temperament and Pain Response: A Review of the Literature (2008)
Pain Management Nursing, 9 (1), 2-9 - Theoretical, Psychometric, and Pragmatic Issues in Pain Measurement (2008)
Pain Management Nursing, 9 (3), 120-130 - Current Controversies Regarding Pain Assessment in Neonates (2007)
Seminars in Perinatology, 31 (5), 283-288 - Continuous axillary block for paediatric trauma patients who failed with PCA therapy (2006)
Acute Pain, 8 (4), 181-184 - Horner's syndrome following thoracic epidural analgesia in children: A report of two cases (2006)
Acute Pain, 8 (2), 83-86
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