The Soothing Power of Music

Do you have a favorite song, band, orchestra, genre of music?  Recall the last movie you saw and the profound effect music had on evoking emotions related to the film.  The power of music is unquestionable, and it's occupied an important place in human history.  Small wonder then, we opine this week on PodMed, that music has been shown to be helpful to folks who are intubated in the ICU, as published in JAMA.  Here's what happened in the study:

A total of 373 patients were randomized to one of three interventions:  patient-directed music (naturally with the acronym PDM), noise canceling headphones, or usual care.  The PDM was selected by the patient with the assistance of a music therapist and could be listened to at their discretion while on mechanical ventilation in the ICU. Headphones were also available at the patient's discretion. The goal of the study was to determine whether analgesic and sedative use could be reduced among conscious patients who were intubated since these medications are associated with a host of negative side effects and outcomes, including slowed heart rate, lowered blood pressure, reduced gut motility, immobility, weakness and delirium.  Unrelieved anxiety and increased stress may give rise to short term problems with recuperation as well as post-traumatic stress disorder once discharge has taken place.

Those patients who were randomized to the music arm of the study experienced a 38% reduction in the use of sedatives and a 36% reduction in sedation intensity.  The music group listened almost 80 minutes per day, compared to 34 minutes per day of noise-canceling headphone use. The patients were studied for a mean of 5.7 days.  Both PDM and noise canceling headphone groups reported less anxiety although the PDM group reported a greater reduction than the headphone group.  Hmmm.  Sounds like (no pun intended) use of patient-directed music should be employed immediately for those patients who must be intubated and are conscious in the ICU.  Its advantages are multiple: it's inexpensive, it's easy, it gives the patient a bit of control over their environment where such control is apparently and sadly lacking, and it appears to reduce the need for medications that are known to have a host of side effects.  It also doesn't interfere with the working aspect of the ICU, since music listening isn't disruptive and doesn't get in the way.  I can envision a day where when patients enter the hospital they are queried on their music preferences much as they currently are on religious preferences.  I would even go so far as to suggest that we should advocate for this practice right now, even in the absence of objective evidence (GASP!) and use headphones and preferred music in every patient in the ICU.  That's in deference to abundant evidence suggesting that even when people are apparently unresponsive they are still aware on some level, and strategies to alleviate anxiety could bear fruit, as well as give family members something to do to help their loved one.  Just an idea.

Other topics this week include predicting acute exacerbations of COPD with inflammatory markers, also in JAMA, the CDC's look at MERS, and the consequences of childhood cancer treatment in adults, back to JAMA.  Until next week, y'all live well.

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The Soothing Power of Music | jhublogs
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Stephen in Oklahoma City June 26, 2013 at 10:35 pm

This was such a great post and it really stirred up some emotion in me because I have always been a big fan of the effects that the right music can have in great movies. I remember when I was a child, there was this move "Dragon Heart" that was a favorite of mine and my brother. Well, the ending song always used to give me goosebumps when it played. To this day, that is when I know a song has really been able to get to me, when it produces those goosebumps. That is a powerful effect!

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