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Effect of a personalized music intervention on stress reduction in the pediatric intensive care unit: a pilot study [copy] [copy] [copy]

Keywords:
child outcome music therapy Critically ill children

Researchers:
Dr. M.C.J. Kneyber
prof. dr. AF Bos

Type of project:
Pilot project (year 2 or 3), Stage Wetenschap / Researchproject of MD/PhD programme

Nature of the research:
Clinical

Fields of study:
pediatrics intensive care

Background / introduction
Admission into a pediatric intensive care unit (PICU) can be a highly stressful experience, with many children demonstrating posttraumatic stress symptoms. Most patients require titration of pain and sedation medications to facilitate care, but there is increasing concern of the impact of these medications on the developing brain and increased health risks. One potential nonpharmacologic approach to decreasing stress and improving comfort is live-performed music therapy.
Research question / problem definition
We want to study in mechanically ventilated, critically ill children < 5 years of age, the effects of live-music therapy on patient comfort, and on patient and parental stress levels and parent-child interaction, use of sedato-analgesic drugs, on hemodynamics and respiration and on the occurrence of patient-ventilator synchrony.
Workplan
We will randomize 25 children to receive live-music therapy for up to two weeks, with three 30 minute sessions a week in which 10 to 20 minutes of music is provided by a trained music therapist in the presence of parents, and 25 to care as usual. The main study endpoint is patient comfort measured with the Dutch Version of the COMFORT Behavior scale; secondary endpoints include parental stress levels, changes in hemodynamic (heart rate, blood pressure) and respiratory parameters (respiration rate, oxygen saturation, pressure-rate product, pressure-time product), on-demand boluses and daily cumulative dose of benzodiazepines and opioids, number of asynchronous breaths and stress genes DNA methylation. Parents are very much involved in this research project, as the music therapist will collaborate with them in constructing the music program
References
Nelson LP, Lachman, SE, Li, SW, Gold, JI (2019) The Effects of Family Functioning on the Development of Posttraumatic Stress in Children and Their Parents Following Admission to the PICU. Pediatr Crit Care Med 20: e208-e215
2. Curley MA, Wypij, D, Watson, RS, Grant, MJ, Asaro, LA, Cheifetz, IM, Dodson, BL, Franck, LS, Gedeit, RG, Angus, DC, Matthay, MA, Investigators, RS, the Pediatric Acute Lung, I, Sepsis Investigators, N (2015) Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. JAMA 313: 379-389
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