Effect of Personalized Music Intervention in Mechanically Ventilated Children in Pediatric ICU: A Pilot Study
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2019-10-25Author
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<jats:sec> <jats:title>Objectives:</jats:title> <jats:p>To determine the feasibility of a personalized music intervention with mechanically ventilated patients in the PICU.</jats:p> </jats:sec> <jats:sec> <jats:title>Design:</jats:title> <jats:p>Pilot study with a quasi-experimental design.</jats:p> </jats:sec> <jats:sec> <jats:title>Setting:</jats:title> <jats:p>Tertiary children’s hospital in China with a 40-bed PICU.</jats:p> </jats:sec> <jats:sec> <jats:title>Patients:</jats:title> <jats:p>Children, 1 month to 7 years, with mechanical ventilation were recruited and assigned to music group (<jats:italic toggle="yes">n</jats:italic> = 25) and control group (<jats:italic toggle="yes">n</jats:italic> = 25).</jats:p> </jats:sec> <jats:sec> <jats:title>Interventions:</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Measurements and Main Results:</jats:title> <jats:p>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; <jats:italic toggle="yes">p</jats:italic> = 0.011). Children in the music group had better physiologic outcomes; heart rate (140 vs 144; <jats:italic toggle="yes">p</jats:italic> = 0.039), respiration rate (40 vs 43; <jats:italic toggle="yes">p</jats:italic> = 0.036), systolic blood pressure (93 vs 95 mm Hg; <jats:italic toggle="yes">p</jats:italic> = 0.031), oxygen saturation (96% vs 95%; <jats:italic toggle="yes">p</jats:italic> < 0.001), diastolic blood pressure was not significantly (52 vs 53 mm Hg; <jats:italic toggle="yes">p</jats:italic> = 0.11). Children in the music group had a shorter ventilation time (148.7 vs 187.6; <jats:italic toggle="yes">p</jats:italic> = 0.044) and a shorter length of stay, but not significant (11.2 vs 13.8; <jats:italic toggle="yes">p</jats:italic> = 0.071). Children in the control group had higher total amount of on-demand midazolam (29 vs 33 mg; <jats:italic toggle="yes">p</jats:italic> = 0.040).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>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.</jats:p> </jats:sec>
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