Music Use for Sedation in Critically ill Children (MUSiCC trial): a pilot randomized controlled trial

Gonzalo Garcia Guerra1,2, Ari R Joffe3,4, Cathy Sheppard4

  • 1Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada. gonzalo.guerra@ahs.ca.

Journal of Intensive Care
|January 12, 2021
PubMed

Insights

This pilot study shows that music medicine interventions are feasible in pediatric intensive care units. The trial provided data to plan larger studies on music

Area of Science:

  • Pediatric Intensive Care Medicine
  • Music Therapy
  • Clinical Trial Design

Background:

  • Critically ill children in intensive care often require sedation and analgesia.
  • Feasibility of non-pharmacological interventions like music therapy in this population is not well-established.

Purpose of the Study:

  • To assess the feasibility of a music medicine intervention trial in pediatric intensive care.
  • To gather data on sedation and analgesia use for future larger trials.

Main Methods:

  • Pilot randomized controlled trial (RCT) involving children aged 1 month to 16 years on mechanical ventilation.
  • Patients were randomized to receive classical music, noise cancellation, or usual care.
  • Interventions were administered for 30 minutes, three times daily.

Main Results:

  • The study enrolled 60 patients with a feasible enrollment rate and acceptable consent rate.
  • Protocol adherence exceeded 80%, and no adverse events were reported.
  • A statistically significant decrease in heart rate was observed during music intervention, with positive parental feedback on comfort and child settling.

Conclusions:

  • Music medicine interventions are feasible in pediatric intensive care settings.
  • The pilot study successfully gathered essential data for designing a larger, powered clinical trial.
Abstract

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
425
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
1.0K
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
336
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
687
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
399
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.1K