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Music interventions for mechanically ventilated patients.

Joke Bradt1, Cheryl Dileo

  • 1Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, 1601 Cherry Street, room 7112, Philadelphia, PA, 19102, USA. jbradt@drexel.edu.

The Cochrane Database of Systematic Reviews
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Summary

Music listening significantly reduces anxiety in patients on mechanical ventilation. This non-pharmacological approach also lowers respiratory rate and systolic blood pressure, potentially decreasing sedative and analgesic use.

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Area of Science:

  • Critical Care Medicine
  • Psychology
  • Evidence-Based Practice

Background:

  • Mechanical ventilation is associated with significant patient distress and anxiety due to factors like breathlessness, isolation, and fear.
  • Pharmacological interventions for anxiety may prolong ventilation and increase healthcare costs, highlighting the need for non-pharmacological alternatives.
  • Music interventions have shown promise in reducing anxiety in general medical patients, but their specific efficacy in mechanically ventilated patients requires evaluation.

Purpose of the Study:

  • To update a previous review examining the effects of music therapy or music medicine on anxiety and other outcomes in mechanically ventilated patients.
  • To conduct a meta-analysis comparing music interventions plus standard care versus standard care alone.
  • To compare patient-selected versus researcher-selected music and different types of music interventions.

Main Methods:

  • A comprehensive search of multiple electronic databases (e.g., CENTRAL, MEDLINE, CINAHL, EMBASE) and other sources was conducted up to March 2014.
  • Included were randomized and quasi-randomized controlled trials comparing music interventions with standard care in mechanically ventilated patients.
  • Data extraction and quality assessment were performed independently by two reviewers; meta-analyses used mean differences and risk ratios.

Main Results:

  • Music listening demonstrated a large and clinically significant reduction in anxiety (1.11 SD units) compared to standard care.
  • Music listening consistently reduced respiratory rate and systolic blood pressure, indicating a relaxation response.
  • Trends suggest reduced sedative and analgesic intake, though one study noted higher sedation scores; evidence for other physiological measures and mortality was inconsistent or limited.

Conclusions:

  • Music listening appears to be a beneficial intervention for reducing anxiety in mechanically ventilated patients, consistent with findings in other medical populations.
  • The intervention consistently lowers key physiological indicators of stress, such as respiratory rate and systolic blood pressure.
  • Music interventions represent a viable, non-pharmacological option for anxiety management in this patient group, potentially impacting sedative and analgesic requirements.