DOI: 10.1097/ccm.0000000000007372 ISSN: 0090-3493

Music Therapy During Weaning From Invasive Mechanical Ventilation in the ICU: A Randomized Controlled Trial

Sheila Pereiro, Esther Corral, Patxi Del Campo, Ana Vallejo, Julene Argaluza, Esperanza Torres, Amaia Quintano, Sergio Castaño, Sara Cabañes, Pablo García, Stine L. Jacobsen, Bolette Daniels Beck
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Objectives:

The study examined the effect of daily music therapy on weaning from invasive mechanical ventilation (IMV) in the ICU, with a primary focus on weaning duration. Secondary agitation, sedation, and analgesia doses, pain, delirium, and perceived stress after 90 days were assessed. Additionally, total IMV and ICU stay durations and tracheostomy rates were studied. Physiologic parameters were assessed in the music therapy group (MG). The study also aimed to promote the humanization of critical care through a biopsychosocial and creative music therapy approach.

Design:

Randomized controlled trial with two parallel groups: control group receiving standard care during weaning and MG receiving music therapy additionally.

Setting and Patients:

Adult critically ill patients ( n = 100) admitted to a general ICU who received IMV for at least 48 hours.

Interventions:

MG received daily, individualized music therapy sessions averaging 25 minutes, based on patient needs and musical preferences, which included music relaxation, music listening, and clinical improvisation.

Measurements and Main Results:

No significant difference in weaning duration was observed between groups ( p = 0.97). Patients in the MG group showed significant improvements in agitation and sedation levels (Richmond Agitation-Sedation Scale) on days 1 and 3 ( p = 0.048, 0.005, and 0.024) and a lower percentage required propofol ( p = 0.028). No significant difference in perceived pain (Visual Analog Pain Scale). The MG obtained lower Perceived Stress Scale-14 scores ( p = 0.24). Additionally, MG significantly reduced tracheostomy rates (14%; p = 0.025). Median total IMV and ICU stay duration were shorter in the MG group, but not significantly ( p = 0.206 and 0.203). Heart rate, respiratory rate, blood pressure, and oxygenation showed no significant difference before and after music therapy.

Conclusions:

Music therapy may serve as a nonpharmacological complementary adjunct during weaning by reducing agitation, sedation, and tracheostomy rate. It may potentially decrease perceived stress and IMV and ICU stay durations. Further research is warranted.

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