Music Therapy During Basic Daily Care in Critically Ill Children: A Randomized Crossover Clinical Trial
Journal
The Journal of Pediatrics
Year
2024
Abstract
OBJECTIVE: To assess whether music therapy (MT) is effective to reduce pain during daily personal hygiene care (DPHC), a procedure performed in all patients in a pediatric intensive care unit. METHODS: Fifty critically ill children were enrolled in a crossover controlled clinical trial with random ordering of the intervention, that is, passive MT, and standard conditions, and blind assessment of pain on film recordings. The primary outcome was variation of the Face Legs Activity Cry Consolability (FLACC) score (range, 0-10) comparing before and during DPHC. Secondary outcomes were changes in heart rate, respiratory rate, and mean arterial blood pressure, and administration of analgesic or sedative drugs during DPHC. Mixed-effects linear model analysis was used to assess effect size (95% CI). RESULTS: The median (Q25-Q75) age and weight of the patients were 3.5 years (1.0-7.6 years) and 15.0 kg (10.0-26.8 kg). Consecutive DPHC were assessed on days 3 (2-5) and 4 (3-7) of hospitalization. In standard conditions, FLACC score was 0.0 (0.0-3.0) at baseline and 3.0 (1.0-5.5) during DPHC. With MT, these values were, respectively, 0.0 (0.0-1.0) and 2.0 (0.5-4.0). Rates of FLACC scores of >4 during DPHC, which indicates severe pain, were 42% in standard conditions and 17% with MT (P = .013). Mixed-effects model analysis found smaller increases in FLACC scores (-0.54 [-1.08 to -0.01]; P = .04) and heart rate (-9.00; [-14.53; -3.40]; P = .001) with MT. CONCLUSIONS: MT is effective to improve analgesia in critically ill children exposed to DPHC. TRIAL REGISTRATION: This study was recorded (April 16, 2019) before patient recruitment on the National Library of Medicine registry (NCT03916835; https://clinicaltrials.gov/ct2/show/NCT03916835).
Music and Health Institute Terms
Pain; Pain Management and Control; Hospital Setting; Intensive Care Unit (ICU); Subjective Measures; Physiological Measures; Music Listening; Music Medicine
Indexed Terms
Children; Critical Illness; Crying; FLACC scale; Pain; Pain Measurement; daily personal hygiene care; nonpharmacological therapies; procedural pain
Study Type
Randomized Controlled Trial; Quantitative Methods
PubMed ID
PMID: 37722559
Document Type
Article
Recommended Citation
Mounier, S., Cambonie, G., Baleine, J., Le Roux, M., Bringuier, S., & Milési, C. (2024). Music Therapy During Basic Daily Care in Critically Ill Children: A Randomized Crossover Clinical Trial. The Journal of Pediatrics, 264, 113736. Retrieved from https://remix.berklee.edu/mhi-citations/1737