Jessica Jarvis, PhD, MT-BC
Assistant Professor
University of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure information not submitted.
Sheri Robb, PhD, MT-BC
Professor
Indiana University, United States
Disclosure information not submitted.
Amy Houtrow, MD, PhD, MPH
Professor
Children's Hospital of Pittsburgh of UPMC, United States
Disclosure information not submitted.
Amery Treble-Barna, PhD
Assistant Professor
University of Pittsburgh School of Medicine, United States
Disclosure information not submitted.
Zachary Henry, BA
Research Coordinator
University of Pittsburgh, United States
Disclosure information not submitted.
Kory Antonacci, MS Ed, LPC, MT-BC
Creative and Expressive Arts Therapy Program Coordinator
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Nicole Steele, MS, MT-BC
Music Therapist
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Brittany Meyer, MM, MT-BC
Music Therapist
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Amy Wagner, MD
Professor
University of Pittsburgh Medical Center, United States
Disclosure information not submitted.
Charity Patterson, PhD, MSPH
Professor
University of Pittsburgh, United States
Disclosure information not submitted.
.jpg "Patrick Kochanek, MD, MCCM photo")
Patrick Kochanek, MD, MCCM
Director, Safar Center for Resuscitation Research
UPMC Presbyterian
Pittsburgh, Pennsylvania
Disclosure information not submitted.
Ericka Fink, MD, FCCM
Childrens Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania
Disclosure information not submitted.
Title: Feasibility of a Music Therapy Intervention in the Pediatric Intensive Care Unit
INTRODUCTION/HYPOTHESIS: Mechanical ventilation (MV) in the pediatric intensive care unit (PICU) increases risk of stress and pain. PICU standard of care to treat stress and pain is a pharmacologic approach, but this increases risk of poor outcomes (e.g., delirium). Listening to music during MV in adults can decrease stress, pain, and medication use. Data are needed to implement a music intervention in the PICU. Our objectives were (1) to determine feasibility of providing live music by a music therapist during MV in the PICU and completing proposed data collection, and (2) to obtain caregiver input on intervention acceptability and optimizations.
Methods: This single-group feasibility trial enrolled 20 families of children 2 months–17 years old who required MV with anticipated PICU length of stay ³72 hrs. Children received 20-min music therapy sessions 3x/week until they returned to baseline respiratory status or for 2 weeks, whichever came first. Music therapists provided live music (singing with guitar) of child preferred songs in a calming manner (e.g., 60-80 beats per min). We collected saliva and physiologic-based biomarkers of stress and pain, patient reported outcome (PRO) on caregiver anxiety pre/post session, nurse-reported delirium and pain scores, and PRO on child emotional health at PICU discharge. We conducted semi-structured interviews with caregivers to ascertain their perception of intervention benefits, limitations, and optimizations.
Results: Of 1,000 children screened from June 2020-February 2021, 29 met inclusion criteria, and 20 (69%) consented and were enrolled. Children received a median (IQR) of 2.5 (2.0-4.0) music therapy sessions. Intervention protocol adherence was 100%. Saliva and physiologic-based biomarker data were 88% and 96% complete, respectively. PRO data completion was 64-88%. In qualitative interviews (n=15), caregivers stated music therapy was calming for them and their child, the duration was adequate, but frequency was inadequate. Caregivers suggested providing recorded music playlists to supplement between music therapy sessions as needed.
Conclusions: Results suggest enrollment and adherence to a music therapy intervention for children treated with MV in the PICU is feasible and acceptable. Future trials should explore increasing dose via combining live and recorded music.