Music Listening in the ICU – Increase in Sedation

The experience of being in the ICU of a hospital could be extreemly stressful for the patient and family. Finding low-cost interventions that can reduce stress could be helpful in these situations. A recent study examined the effect of music listening on stress and anxiety levels in sedated patients who were on mechanical ventilation.

Dijkstra et al. (2010) used music listening as an intervention for patients on mechanical ventilation in a RCT pilot study. The intervention consisted of three 30-minute music listening periods spread over two days. Measurements included blood pressure, heart rate, respiratory rate, and sedation level.  Although physiological parameters did not reach significance, patients in the experimental group had higher sedation scores (see Ramsay Scale below).

This is some nice RCT evidence supporting the use of music in the ICU. I have to wonder why the physiological measures didn’t change with the greater level of sedation.  This could be the result of the sedative drugs administered to the patients, length of treatment, or type of music offered. Music selection in this study was limited to classical and easy listening. If not preferential these may not decrease stress or physiological parameters. The authors recognized these potential deficits in the study and concluded that they may need to reconsider the music treatment offered in future studies.

Clinical Implications: This study was on music listening and not music therapy. The addition of the therapist to the intervention may yield different results. Some music therapists may use music listening and this is some nice emerging evidence supporting the use of music with sedated patient on mechanical ventilation in the ICU.  Music Therapists working in the ICU may provide similar services and this would support the use of music listening for increased sedation in these patients. This study also showed that there were no deleterious effects of recorded music in the ICU. Music Therapists in this setting should continue to consider the client’s preferred music.

Ramsay Sedation Scale
1   Patient is anxious and agitated or restless, or both
2   Patient is co-operative, oriented, and tranquil
3   Patient responds to commands only
4   Patient exhibits brisk response to light glabellar tap or loud auditory stimulus
5   Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus
6   Patient exhibits no response

Reference:

Dijkstra, B.M., Gamel, C., van der Bijl, J.J., Bots, M.L., & Kesecioglu, J. (2010). The effects of music on physiological responses and sedation scores in sedated, mechanically ventilated patients. J Clin Nurs., 19(7-8), 1030-9. PMID: 20492047