A systematic review of the comparative effects of sound and music interventions for intensive care unit patients' outcomes

Elizabeth Papathanassoglou; Usha Pant; Shaista Meghani; Neelam Saleem Punjani; Yuluan Wang; Tiffany Brulotte; Krooti Vyas; Liz Dennett; Lucinda Johnston; Demetrios James Kutsogiannis; Stephanie Plamondon; Michael Frishkopf

doi:10.1016/j.aucc.2024.101148

A systematic review of the comparative effects of sound and music interventions for intensive care unit patients' outcomes

Aust Crit Care. 2024 Dec 27:101148. doi: 10.1016/j.aucc.2024.101148. Online ahead of print.

Affiliations

¹ Faculty of Nursing, University of Alberta, Neurosciences Rehabilitation & Vision Strategic Clinical Network™, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: papathan@ualberta.ca.
² Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: upant@ualberta.ca.
³ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: shaista@ualberta.ca.
⁴ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: npunjani@ualberta.ca.
⁵ Faculty of Rehabilitation Medicine, University of Alberta, 1-45 Corbett Hall, Edmonton, AB, T6G 2G4, Canada. Electronic address: yuluan@ualberta.ca.
⁶ University of Alberta, Faculty of Arts, Department of Music, Canada. Electronic address: tbrulott@ualberta.ca.
⁷ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: krooti@ualberta.ca.
⁸ Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton Clinic Health Academy, Edmonton AB, T6G 1C9, Canada. Electronic address: liz.dennett@ualberta.ca.
⁹ Rutherford Humanities & Social Sciences Library, 1-01 Rutherford Library South, University of Alberta, Edmonton, AB, T6G 2J8, Canada. Electronic address: lucinda.johnston@ualberta.ca.
¹⁰ Critical Care Medicine, Neurocritical Care (UCNS), Neurointensivist/Scientist, Neurosciences ICU, The University of Alberta, Royal Alexandra Hospital ICU, Hospital Neurosciences ICU, 616 CSC Royal Alexandra Hospital, 10240 Kingsway Avenue, Edmonton, AB, T5H-3V9, Canada.
¹¹ University of Calgary, Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Mathison Centre for Mental Health Research & Education, South Health Campus, Canada. Electronic address: splamond@ucalgary.ca.
¹² Department of Music, Canadian Centre for Ethnomusicology (CCE), Department of Performing Arts, Faculty of Communication and Media Studies, University for Development Studies, Ghana; Department of Music, Faculty of Arts, University of Alberta, 3-98 Fine Arts Building, Edmonton, AB, T6G 2C9, Canada. Electronic address: michaelf@ualberta.ca.

PMID: 39732575
DOI: 10.1016/j.aucc.2024.101148

Abstract

Background: Despite syntheses of evidence showing efficacy of music intervention for improving psychological and physiological outcomes in critically ill patients, interventions that include nonmusic sounds have not been addressed in reviews of evidence. It is unclear if nonmusic sounds in the intensive care unit (ICU) can confer benefits similar to those of music.

Objective: The aim of this study was to summarise and contrast available evidence on the effect of music and nonmusic sound interventions for the physiological and psychological outcomes of ICU patients based on the results of randomised controlled trials.

Methods: This systematic review was directed by a protocol based on the Methodological Expectations of Cochrane Intervention Reviews. Quality of studies was assessed with the Cochrane risk of bias assessment tool. Searches were performed in the following databases: MEDLINE, Embase, APA PsycInfo, CINAHL Plus with Full Text, Academic Search Complete, RILM Abstracts of Music Literature, Web of Science, and Scopus.

Results: We identified 59 articles meeting the inclusion criteria, 37 involving music and 22 involving nonmusic sound interventions, with one study comparing music and sound. The identified studies were representative of a general ICU population, regardless of patients' ability to communicate. Our review demonstrated that both slow-tempo music and sound interventions can significantly (i) decrease pain; (ii) improve sleep; (iii) regulate cortisol levels; (iv) reduce sedative and analgesic need; and (v) reduce stress/anxiety and improve relaxation when compared with standard care and noise reduction. Moreover, compared to nonmusic sound interventions, there is more evidence that music interventions have an effect on stress biomarkers, vital signs, and haemodynamic measures.

Conclusion: These results raise the possibility that different auditory interventions may have varying degrees of effectiveness for specific patient outcomes in the ICU. More investigation is needed to clarify if nonmusic sound interventions may be equivalent or not to music interventions for the management of discrete symptoms in ICU patients.

Registration of reviews: The protocol was registered on Open Science Framework in November 6 2023 (https://doi.org/10.17605/OSF.IO/45F6E).

Keywords: Critical care; Intensive care unit; Music; Pain; Physiological outcomes; Psychological outcomes; Sleep; Sound; Soundscapes; Systematic review.

Publication types

Review