Effects of music therapy in itensive care unit without sedation in weaning patients versus non-ventilated patients

Objectives. - Music has been found to be an effective nonpharmacologic adjunct for managing anxiety and promoting relaxation in limited trials of critically ill patients. However, its effects have not been compared in intubated patients during weaning from mechanical ventilation with non-intubated patients spontaneously breathing. Study design. - A cross-over randomized experimental design. Patients and Methods. - Thirty patients were studied (intubated group n = 15, non-intubated group n 15). Patients were randomized to receive either 20 minutes of uninterrupted rest or then 20 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients selected a relaxing music of their choice from a selection including different types of music. Heart rate (HR), systolic blood pressure (SAP), respiratory rate (RR) and bispectral index (BIS score) were recorded each 5-min intervals throughout both periods (rest and music). Agitation/sedation state and pain were evaluated by the Richmond-Agitation-Sedation-Scale (RASS) and the Numerical-Rating-Scale (NRS) respectively, before and after each studied periods. Music have not been performed in five patients (5/35 = 14%). Results. - Music significantly decreased HR (88 +/- 15 vs 82 +/- 15, P < 0.05), SAP (137 +/- 17 vs 128 +/- 14, P < 0.05), RR (25 +/- 3 vs 22 +/- 4, P < 0.05), BIS (94 +/- 5 vs 81 +/- 10, P < 0.01), RASS (+0.1 +/- 0.7 vs -0.7 +/- 0.9, P < 0.05) and NRS (4.4 +/- 1.7 vs 1.9 +/- 1.3, P < 0.01) in both intubated and non-intubated groups whereas no significant change was observed during the rest period. The variations level studied parameters induced by music were comparable for the two groups. Conclusion. - A single music therapy session was found to be effective for decreasing anxiety and promoting relaxation, as indicated by decreases in heart rate, blood pressure, BIS and respiratory rate over the intervention period in intubated patients during weaning phase. (c) 2006 Elsevier Masson SAS. Tous droits reserves.