Papathanassoglou Elizabeth, Pant Usha, Meghani Shaista, Saleem Punjani Neelam, Wang Yuluan, Brulotte Tiffany, Vyas Krooti, Dennett Liz, Johnston Lucinda, Kutsogiannis Demetrios James, Plamondon Stephanie, Frishkopf Michael
Faculty of Nursing, University of Alberta, Neurosciences Rehabilitation & Vision Strategic Clinical Network™, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
Aust Crit Care. 2025 May;38(3):101148. doi: 10.1016/j.aucc.2024.101148. Epub 2024 Dec 27.
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.
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.
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.
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.
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.
The protocol was registered on Open Science Framework in November 6 2023 (https://doi.org/10.17605/OSF.IO/45F6E).
尽管已有证据综合表明音乐干预对改善重症患者的心理和生理结局有效，但在证据综述中尚未涉及包含非音乐声音的干预措施。目前尚不清楚重症监护病房（ICU）中的非音乐声音是否能带来与音乐类似的益处。
本研究旨在根据随机对照试验的结果，总结和对比音乐与非音乐声音干预对ICU患者生理和心理结局影响的现有证据。
本系统综述遵循基于Cochrane干预综述方法学期望的方案进行。采用Cochrane偏倚风险评估工具对研究质量进行评估。检索了以下数据库：MEDLINE、Embase、APA PsycInfo、CINAHL Plus with Full Text、Academic Search Complete、RILM Abstracts of Music Literature、Web of Science和Scopus。
我们确定了59篇符合纳入标准的文章，其中37篇涉及音乐，22篇涉及非音乐声音干预，有一项研究比较了音乐和声音。所纳入的研究代表了一般ICU患者群体，无论患者的沟通能力如何。我们的综述表明，与标准护理和降噪措施相比（i）慢节奏音乐和声音干预均可显著减轻疼痛；（ii）改善睡眠；（iii）调节皮质醇水平；（iv）减少镇静和镇痛需求；（v）减轻压力/焦虑并促进放松。此外，与非音乐声音干预相比，有更多证据表明音乐干预对压力生物标志物、生命体征和血流动力学指标有影响。
这些结果提示，不同的听觉干预措施对ICU患者特定的结局可能具有不同程度的有效性。需要更多研究来明确在管理ICU患者的离散症状方面，非音乐声音干预是否等同于音乐干预。
该方案于2023年11月6日在开放科学框架上注册（https://doi.org/10.17605/OSF.IO/45F6E）。
