The effect of listening to music during continuous positive airway pressure on agitation levels and compliance of intensive care patients with COVID-19: A randomized controlled trial.

BACKGROUND

Agitation and incompliance with the treatment may be observed in patients undergoing continuous positive airway pressure (CPAP), which may cause inadequate oxygenation, sedation, termination of CPAP or intubation of the patient.

AIM

This study was conducted to determine the effect of listening to music during CPAP on the agitation levels of intensive care patients who underwent CPAP as a result of COVID-19 and their compliance with the treatment.

STUDY DESIGN

This study was a prospective, randomized, controlled clinical trial. Seventy-six intensive care patients with COVID-19 were included in this study and assigned to the music and control groups via the block randomization method. The study was completed with 70 patients. The patients and outcome assessors were not blinded in this study. The Richmond Agitation and Sedation Scale (RASS) level, respiratory rate, oxygen saturation (SpO ) and mask air leakage amount were the outcome measures.

RESULTS

The mean RASS score of the patients in the intervention group was 2.14 ± 0.69 before CPAP, 1.63 ± 064 at the 1st minute, 0.89 ± 0.58 at the 15th minute and 0.74 ± 0.61 at the 30th minute. The mean RASS score of the patients in the control group was 2.06 ± 0.53 before CPAP, 1.80 ± 0.58 at the 1st minute, 1.43 ± 0.60 at the 15th minute and 1.46 ± 0.61 at the 30th minute of CPAP. There was a statistically significant difference between the groups at the 15th and 30th minutes (t = -3.81, p < .001; t = -4.89, p < .001 respectively). The mean respiratory rate, SpO and mask air leakage amount were compared between the groups. There was a statistically significant difference in favour of the intervention group at the 15th minute (t = -2.47, p < .001; t = 2.57, p < .001; t = 2.93, p < .001 respectively) and 30th minute (t = -3.17, p < .001; t = 3.46, p < .001; t = -3.93, p < .001 respectively).

CONCLUSIONS

The study results show that listening to music during CPAP reduces the agitation levels of patients and helps them comply with the treatment.

RELEVANCE TO CLINICAL PRACTICE

Music may be a beneficial application for patients who are agitated and unable to comply with CPAP therapy. This is an easy and applicable method, which can protect patients from the adverse effects of failed CPAP.