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Music interventions for mechanically ventilated patients

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Abstract

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Background

Mechanical ventilation often causes major distress and anxiety in patients. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients; however its efficacy for mechanically ventilated patients needs to be evaluated.

Objectives

To examine the effects of music interventions with standard care versus standard care alone on anxiety and physiological responses in mechanically ventilated patients.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 1), MEDLINE, CINAHL, AMED, EMBASE, PsycINFO, LILACS, Science Citation Index, www.musictherapyworld.net, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the National Research Register, and NIH CRISP (all to January 2010). We handsearched music therapy journals and reference lists and contacted relevant experts to identify unpublished manuscripts. There was no language restriction.

Selection criteria

We included all randomized and quasi‐randomized controlled trials that compared music interventions and standard care with standard care alone for mechanically ventilated patients.

Data collection and analysis

Two authors independently extracted the data and assessed the methodological quality. Additional information was sought from the trial researchers, when necessary. Results were presented using mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Post‐test scores were used. In cases of significant baseline difference, we used change scores.

Main results

We included eight trials (213 participants). Music listening was the main intervention used, and seven of the studies did not include a trained music therapist. Results indicated that music listening may be beneficial for anxiety reduction in mechanically ventilated patients; however, these results need to be interpreted with caution due to the small sample size. Findings indicated that listening to music consistently reduced heart rate and respiratory rate, suggesting a relaxation response. No strong evidence was found for blood pressure reduction.

Music listening did not improve oxygen saturation level.

No studies could be found that examined the effects of music interventions on quality of life, patient satisfaction, post‐discharge outcomes, mortality, or cost‐effectiveness.

Authors' conclusions

Music listening may have a beneficial effect on heart rate, respiratory rate, and anxiety in mechanically ventilated patients. However, the quality of the evidence is not strong. Most studies examined the effects of listening to pre‐recorded music. More research is needed on the effects of music offered by a trained music therapist.

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Plain language summary

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Music interventions for mechanically ventilated patients

Mechanical ventilation often causes major distress and anxiety in patients, putting them at greater risk for complications. Side effects of analgesia and sedation may lead to the prolongation of mechanical ventilation and, subsequently, to a longer length of hospitalization and increased cost. Therefore, non‐pharmacological interventions should be considered for anxiety and stress management. This review included eight randomized and quasi‐randomized controlled trials with a total of 213 participants. The findings suggest that music listening may have a beneficial effect on heart rate, respiratory rate, and state anxiety in mechanically ventilated patients.

No evidence of effect was found for blood pressure or oxygen saturation level. However, only a small number of trials investigated the effects of music on these outcomes. More research is needed.

The vast majority of the studies examined the effects of patients' listening to pre‐recorded music. More research is needed on the effects of music offered by a trained music therapist.