Journal
JOURNAL OF CRITICAL CARE
Volume 28, Issue 4, Pages 442-450Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2013.01.007
Keywords
Music; Stress; ICU; Sedation; Cortisol; Biological markers
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Funding
- RCEL-CHUS (PAFI)
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Purpose: To evaluate the impact of slow-tempo music listening periods in mechanically ventilated intensive care unit patients. Methods: A randomized crossover study was performed in a 16-bed, adult critical care unit at a tertiary care hospital. Still-sedated patients, mandating at least 3 more days of mechanical ventilation, were included. The intervention consisted in two 1-hour daily periods of music-vs-sham-MP3 listening which were performed on Day 1 or 3 post-inclusion, with a Day 2 wash-out. Before-after collection of vital signs, recording of daily sedative drug consumption and measurement of stress and inflammatory blood markers were performed. Results: Of 55 randomized patients, 49 were included in the final analyses. Along with music listening, (i) vital signs did not consistently change, whereas narcotic consumption tended to decrease to a similar sedation (P = .06 vs sham-MP3); (ii) cortisol and prolactin blood concentrations decreased, whereas Adreno Cortico Trophic Hormone (ACTH)/cortisol ratio increased (P = .02; P = .038; and P = .015 vs sham-MP3, respectively), (iii) cortisol responders exhibited reversed associated changes in blood mehionine (MET)-enkephalin content (P = .01). Conclusions: In the present trial, music listening is a more sensitive stress-reliever in terms of biological vs clinical response. The hypothalamus-pituitary adrenal axis stress axis is a quick sensor of music listening in responding mechanically ventilated intensive care unit patients, through a rapid reduction in blood cortisol. (C) 2013 Elsevier Inc. All rights reserved.
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