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Effect of Personalized Music Intervention in Mechanically Ventilated Children in the PICU: A Pilot Study
Mei-Hua Liu1, Li-Hui Zhu2, Jian-Xiong Peng1
1Division of Pediatric Intensive Care Unit, Hunan Children's Hospital, Ziyuan Rd. Changsha, Hunan, China.
Insights
Personalized music interventions may improve comfort and physiological outcomes for mechanically ventilated children in the pediatric intensive care unit (PICU). This pilot study suggests feasibility and potential benefits, warranting further investigation.
Area of Science:
- Pediatric critical care medicine
- Music therapy
- Patient comfort and well-being
Background:
- Mechanically ventilated children in the pediatric intensive care unit (PICU) often experience discomfort.
- Non-pharmacological interventions are sought to improve patient outcomes and reduce distress.
Purpose of the Study:
- To assess the feasibility of a personalized music intervention for mechanically ventilated children in a PICU.
- To evaluate the impact of music on comfort, physiological variables, and clinical outcomes.
Main Methods:
- A pilot study with a quasi-experimental design was conducted in a tertiary children's hospital PICU.
- Children (1 month to 7 years) on mechanical ventilation were assigned to a music group (n=25) or control group (n=25).
- The music group received 60 minutes of personalized music thrice daily; the control group received routine care.
Main Results:
- The music group showed significantly lower COMFORT Behavior scores (p=0.011) and improved heart rate (p=0.039), respiration rate (p=0.036), systolic blood pressure (p=0.031), and oxygen saturation (p<0.001).
- Mechanically ventilated children in the music group experienced shorter ventilation times (p=0.044).
- Nurses reported positive attitudes towards the intervention, and the control group received more midazolam (p=0.040).
Conclusions:
- Personalized music intervention appears feasible and potentially beneficial for enhancing comfort in mechanically ventilated pediatric patients.
- Further research is necessary to confirm the efficacy of music interventions for critically ill children in PICUs.
Objectives:
To determine the feasibility of a personalized music intervention with mechanically ventilated patients in the PICU.
Design:
Pilot study with a quasi-experimental design.
Setting:
Tertiary children's hospital in China with a 40-bed PICU.
Patients:
Children, 1 month to 7 years, with mechanical ventilation were recruited and assigned to music group (n = 25) and control group (n = 25).
Interventions:
Children in the music group received their own favorite music and listened for 60 minutes three times a day. The control group receive routine care without music.
Measurements And Main Results:
Primary outcome measure was comfort measured with the COMFORT Behavior scale 5 minutes before and after the music. Secondary outcome measures were physiologic variables; heart rate, respiration, blood pressure, oxygen saturation. Mechanical ventilation time, length of stay, and sedation medication were also collected. Qualitative analysis revealed that nurses had a positive attitude in delivering the interventions and identified improvements for the main trial. Children in the music group had lower COMFORT Behavior scores (15.7 vs 17.6; p = 0.011). Children in the music group had better physiologic outcomes; heart rate (140 vs 144; p = 0.039), respiration rate (40 vs 43; p = 0.036), systolic blood pressure (93 vs 95 mm Hg; p = 0.031), oxygen saturation (96% vs 95%; p < 0.001), diastolic blood pressure was not significantly (52 vs 53 mm Hg; p = 0.11). Children in the music group had a shorter ventilation time (148.7 vs 187.6; p = 0.044) and a shorter length of stay, but not significant (11.2 vs 13.8; p = 0.071). Children in the control group had higher total amount of on-demand midazolam (29 vs 33 mg; p = 0.040).
Conclusions:
Our pilot study indicates that personalized music intervention is feasible and might improve the comfort of children with mechanical ventilation. Further studies are needed to provide conclusive evidence in confirming the effectiveness of music interventions comforting critically ill children in PICUs.
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