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Cochrane Database of Systematic Reviews

Music interventions for mechanically ventilated patients

Information

DOI:
https://doi.org/10.1002/14651858.CD006902.pub3Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 09 December 2014see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Emergency and Critical Care Group

Copyright:
  1. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Joke Bradt

    Correspondence to: Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, USA

    [email protected]

  • Cheryl Dileo

    Department of Music Therapy and The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Philadelphia, USA

Contributions of authors

Joke Bradt (JB), Cheryl Dileo (CD) (and in original review Denise Grocke (DG) (Bradt 2010))

Conceiving the review: CD
Co‐ordinating the review: JB
Undertaking manual searches: JB, DG, and graduate assistants
Screening search results: CD,JB, and graduate assistants
Organizing retrieval of papers: JB
Screening retrieved papers against inclusion criteria: JB
Appraising quality of papers: CD and JB
Abstracting data from papers: JB and research assistant
Writing to authors of papers for additional information: JB
Providing additional data about papers: JB
Obtaining and screening data on unpublished studies:CD
Data management for the review: JB
Entering data into Review Manager (RevMan 5.2): JB and research assistant
RevMan statistical data: JB
Other statistical analysis not using RevMan: JB
Double entry of data: (data entered by person one JB; data entered by person two: research assistant)
Interpretation of data: CD, JB, DG for original review; JB and CD for update
Statistical inferences: JB
Writing the review: CD, JB, DG for original review; JB and CD for update
Securing funding for the review: CD for original review; no funding for update
Guarantor for the review (one author): JB
Person responsible for reading and checking review before submission: JB

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • State of Pennsylvania Formula Fund, USA.

    Financial support for the original review (Bradt 2010)

Declarations of interest

Joke Bradt and Cheryl Dileo are music therapists

The original review (Bradt 2010) was partly supported by a grant of the State of Pennsylvania Formula Fund. No funding was received for the update of the review.

Acknowledgements

We would like to thank Harald Herkner (content editor), Nathan Pace (statistical editor), Theresa Davis and Janet Sit (peer reviewers) for their help and editorial advice during the preparation of the update of this systematic review.

We would like to thank Karen Hovhannisyan (Trials Search Co‐ordinator Cochrane Anaesthesia Review Group (CARG)) for his help with the development of the search strategy and Jane Cracknell (Managing Editor, CARG), Prof Harald Herkner (content editor), Dr Marialena Trivella (statistical editor), Dr Megan Prictor (peer reviewer), Yusra Badr and Ann Fonfa (Cochrane Consumer Network) for their help and editorial advice during the preparation of the original review (Bradt 2010).

We would like to thank Dr Linda Chlan (peer reviewer), Clare Jeffrey (consumer), Janet Wale (consumer), Anne Lyddiatt (consumer), and Naseem Akhtar Qureshi (consumer) for their help and editorial advice during the preparation of the protocol of the review.

We would also like to acknowledge Mike Viega, research assistant at Temple University, for his help in the data extraction and data input, and Patricia Gonzalez and Cassandra Mulcahey, graduate assistants at Temple University, for their help with handsearching and article retrieval in the original review. We would like to thank Noah Potvin, research assistant, for his help with handsearching, article retrieval, and screening of search outputs, and Sheau‐Ling Duh for translating studies in the Chinese language. Both are doctoral students in the Department of Creative Arts Therapies at Drexel University.

Finally we would like to thank Dr Denise Grocke for her contributions as co‐author of the original review (Bradt 2010).

Version history

Published

Title

Stage

Authors

Version

2014 Dec 09

Music interventions for mechanically ventilated patients

Review

Joke Bradt, Cheryl Dileo

https://doi.org/10.1002/14651858.CD006902.pub3

2010 Dec 08

Music interventions for mechanically ventilated patients

Review

Joke Bradt, Cheryl Dileo, Denise Grocke

https://doi.org/10.1002/14651858.CD006902.pub2

2008 Jan 23

Music interventions for mechanically ventilated patients

Protocol

Cheryl Dileo, Joke Bradt, Denise Grocke

https://doi.org/10.1002/14651858.CD006902

Differences between protocol and review

Bradt 2010

In the protocol (Bradt 2008), we stated that we would exclude studies that used systematic methods of randomization. However, because only a small number of studies met all inclusion criteria, we decided to include studies that used systematic randomization (for example, alternate assignment). We analysed the impact of these studies by means of sensitivity analysis.

The Specialist Music Therapy Research database is no longer a functional database. However, archives of research reports, dissertations, and conference proceedings are still available for handsearching. The authors handsearched these files.

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Study Flow Diagram ‐ Original Review.
Figures and Tables -
Figure 1

Study Flow Diagram ‐ Original Review.

Study flow diagram ‐ updated review.
Figures and Tables -
Figure 2

Study flow diagram ‐ updated review.

Funnel plot of comparison: 1 Music versus standard care, outcome: 1.4 Respiratory rate.
Figures and Tables -
Figure 3

Funnel plot of comparison: 1 Music versus standard care, outcome: 1.4 Respiratory rate.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 4

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 5

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Comparison 1 Music versus standard care, Outcome 1 State Anxiety (change scores).
Figures and Tables -
Analysis 1.1

Comparison 1 Music versus standard care, Outcome 1 State Anxiety (change scores).

Comparison 1 Music versus standard care, Outcome 2 Heart Rate.
Figures and Tables -
Analysis 1.2

Comparison 1 Music versus standard care, Outcome 2 Heart Rate.

Comparison 1 Music versus standard care, Outcome 3 Heart Rate (adequate randomization).
Figures and Tables -
Analysis 1.3

Comparison 1 Music versus standard care, Outcome 3 Heart Rate (adequate randomization).

Comparison 1 Music versus standard care, Outcome 4 Respiratory Rate.
Figures and Tables -
Analysis 1.4

Comparison 1 Music versus standard care, Outcome 4 Respiratory Rate.

Comparison 1 Music versus standard care, Outcome 5 Respiratory Rate (adequate randomization).
Figures and Tables -
Analysis 1.5

Comparison 1 Music versus standard care, Outcome 5 Respiratory Rate (adequate randomization).

Comparison 1 Music versus standard care, Outcome 6 Systolic Blood Pressure.
Figures and Tables -
Analysis 1.6

Comparison 1 Music versus standard care, Outcome 6 Systolic Blood Pressure.

Comparison 1 Music versus standard care, Outcome 7 Diastolic Blood Pressure.
Figures and Tables -
Analysis 1.7

Comparison 1 Music versus standard care, Outcome 7 Diastolic Blood Pressure.

Comparison 1 Music versus standard care, Outcome 8 Mean Arterial Pressure.
Figures and Tables -
Analysis 1.8

Comparison 1 Music versus standard care, Outcome 8 Mean Arterial Pressure.

Comparison 1 Music versus standard care, Outcome 9 Oxygen Saturation Level (change scores).
Figures and Tables -
Analysis 1.9

Comparison 1 Music versus standard care, Outcome 9 Oxygen Saturation Level (change scores).

Comparison 1 Music versus standard care, Outcome 10 Mortality.
Figures and Tables -
Analysis 1.10

Comparison 1 Music versus standard care, Outcome 10 Mortality.

Summary of findings for the main comparison. Music compared to standard care for mechanically ventilated patients

Music compared to standard care for mechanically ventilated patients

Patient or population: mechanically ventilated patients
Settings: intensive care units
Intervention: music
Comparison: standard care

Outcomes

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

State anxiety
STAI, VAS

The mean state anxiety in the intervention groups was
1.11 standard deviations lower
(1.75 to 0.47 lower)

288
(5 studies)

⊕⊕⊝⊝
low1,2,3,4

Heart rate
beats per minute

The mean heart rate in the intervention groups was
3.95 lower
(6.62 to 1.27 lower)

338
(8 studies)

⊕⊝⊝⊝
very low1,5,6

Respiratory rate
breaths per minute

The mean respiratory rate in the intervention groups was
2.87 lower
(3.64 to 2.10 lower)

357
(9 studies)

⊕⊝⊝⊝
very low1,6

Systolic blood pressure

mmHg

The mean systolic blood pressure in the intervention groups was
4.22 lower
(6.38 to 2.06 lower)

269
(6 studies)

⊕⊝⊝⊝
very low1,7

Diastolic blood pressure

mmHg

The mean diastolic blood pressure in the intervention groups was
2.16 lower
(4.4 lower to 0.07 higher)

269
(6 studies)

⊕⊝⊝⊝
very low1,7

Mean arterial pressure

mmHg

The mean arterial pressure in the intervention groups was
1.79 lower
(4.56 lower to 0.99 higher)

98
(3 studies)

⊕⊝⊝⊝
very low1,7

Oxygen saturation level

The mean oxygen saturation level in the intervention groups was
0.05 lower
(0.67 lower to 0.57 higher)

193
(4 studies)

⊕⊕⊝⊝
low1

CI: Confidence interval

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

1 The majority of the trials were assessed as high risk of bias studies
2 All point estimates favour music although the magnitude of the effect differs across studies
3 Wide confidence interval, however, this is due to the fact that some studies reported very large beneficial effects of music on anxiety
4 Large reduction in anxiety as evidenced by SMD of 1.11
5 Results were inconsistent across studies as evidenced by I² = 62%
6 Somewhat wide confidence interval
7 Wide confidence interval

Figures and Tables -
Summary of findings for the main comparison. Music compared to standard care for mechanically ventilated patients
Comparison 1. Music versus standard care

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 State Anxiety (change scores) Show forest plot

5

288

Std. Mean Difference (IV, Random, 95% CI)

‐1.11 [‐1.75, ‐0.47]

2 Heart Rate Show forest plot

8

338

Mean Difference (IV, Random, 95% CI)

‐3.95 [‐6.62, ‐1.27]

2.1 Final score

2

63

Mean Difference (IV, Random, 95% CI)

‐5.26 [‐13.56, 3.03]

2.2 Change score

6

275

Mean Difference (IV, Random, 95% CI)

‐3.82 [‐6.83, ‐0.82]

3 Heart Rate (adequate randomization) Show forest plot

7

318

Mean Difference (IV, Random, 95% CI)

‐4.01 [‐6.80, ‐1.22]

4 Respiratory Rate Show forest plot

9

357

Mean Difference (IV, Random, 95% CI)

‐2.87 [‐3.64, ‐2.10]

4.1 Final score

3

83

Mean Difference (IV, Random, 95% CI)

‐2.14 [‐4.06, ‐0.22]

4.2 Change score

6

274

Mean Difference (IV, Random, 95% CI)

‐3.01 [‐3.85, ‐2.17]

5 Respiratory Rate (adequate randomization) Show forest plot

8

337

Mean Difference (IV, Random, 95% CI)

‐2.87 [‐3.64, ‐2.09]

6 Systolic Blood Pressure Show forest plot

6

269

Mean Difference (IV, Random, 95% CI)

‐4.22 [‐6.38, ‐2.06]

6.1 Final score

1

14

Mean Difference (IV, Random, 95% CI)

‐9.0 [‐22.40, 4.40]

6.2 Change score

5

255

Mean Difference (IV, Random, 95% CI)

‐4.09 [‐6.28, ‐1.90]

7 Diastolic Blood Pressure Show forest plot

6

269

Mean Difference (IV, Random, 95% CI)

‐2.16 [‐4.40, 0.07]

7.1 Final score

1

14

Mean Difference (IV, Random, 95% CI)

‐3.70 [‐15.17, 7.77]

7.2 Change score

5

255

Mean Difference (IV, Random, 95% CI)

‐2.13 [‐4.58, 0.31]

8 Mean Arterial Pressure Show forest plot

3

98

Mean Difference (IV, Random, 95% CI)

‐1.79 [‐4.56, 0.99]

8.1 Final score

1

20

Mean Difference (IV, Random, 95% CI)

‐4.75 [‐17.81, 8.31]

8.2 Change score

2

78

Mean Difference (IV, Random, 95% CI)

‐1.65 [‐4.49, 1.20]

9 Oxygen Saturation Level (change scores) Show forest plot

4

193

Mean Difference (IV, Random, 95% CI)

‐0.05 [‐0.67, 0.57]

10 Mortality Show forest plot

2

271

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.38, 1.51]

Figures and Tables -
Comparison 1. Music versus standard care