Music Therapy for Ventilated Patients
July 1998; Volume 1: 83
Source: Chlan L. Effectiveness of a music therapy intervention-relaxation and anxiety for patients receiving ventilatory assistance. Heart & Lung 1998;27:169-176.
To test the effects of music therapy on relaxation and anxiety reduction for patients receiving ventilatory assistance, Chlan randomized subjects to either a 30-minute music intervention or a rest period using a two-group, pre-test, post-test design. Fifty-four alert, nonsedated patients (mean age, 57 years; 92% white; 59% female) were enrolled in four urban Midwestern intensive care units. State anxiety, heart, and respiratory rate were measured every five minutes for 30 minutes. The author found that subjects who received music therapy reported significantly less anxiety post-test than controls. Heart and respiratory rates decreased over time in the music therapy group.
COMMENT
For mechanically ventilated pa-tients-often uncomfortable and sometimes confused and restrained-to "Just relax!" is simply impossible. Intramuscular and intravenous sedatives are effective but, of course, sedating. So, why not play Yanni or Michael Bolton instead?
The authors write, "music exerts its effect via entrainment or synchronization of body rhythms with those of the musical selection. The entrainment of body rhythms with relaxing music is thought to decrease sympathetic nervous system activity, resulting in a dampening in the arousability of the central nervous system."
Maybe so. Subjects ventilated for a mean of seven days selected non-lyric classical music (56%), country (28%), easy-listening (12%), and new age (4%) through headphones on cassette. Controls got a darkened room and instructions to think of something pleasant over the 30-minute musical interlude. Mean post-test anxiety significantly decreased for the experimental group but not the controls. Absolute numbers were not given for cardiac and respiratory rates, but both appeared to decline in the music therapy group and not in the control group.
The investigators did not follow their subjects beyond the 30-minute mark. The anxiety scale used had not been tested previously with critically ill subjects. Other confounding factors include the administration of sedative medication to 22 of the 54 subjects before randomization.
Recommendation
Music therapy has intuitive appeal as a modality to influence emotional state, especially anxiety and distress. As long as the selections lie with the patient, music therapy is unlikely to do psychological harm and may reduce anxiety. Does it reduce ventilation time, improve weaning, or reduce medication use? Stay tuned.
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