The impact of music on hypermetabolism in critical illness.
OBJECTIVE
Although the literature on complementary therapy, including music, is vast, there are few studies conducted in a scientific fashion exploring physiologic mechanisms. This review summarizes recent evidence on the effects of music on the hypermetabolic response of critical illness.


RESULTS
Music may restore some of the distorted homeostasis observed in ICU patients, as well as reducing pain and the need for sedation. Music likely reduces alterations in the hypothalamic-anterior pituitary-peripheral hormone axes that produce cortisol and growth hormone. Music may also increase growth hormone levels, which can induce decreased production of cytokines such as IL-6 by white blood cells. Further, ovarian steroid secretion may paradoxically protect women by increasing baseline circulating stress hormones, providing an opportunity for music therapy to intervene effectively. Dopaminergic neurotransmission has been implicated as a means by which music can modulate the central nervous system.


CONCLUSIONS
Music may play an important role as an adjunct therapy in critical care. However, further studies are necessary to elucidate how music can be further integrated clinically and the precise underlying mechanisms of its beneficial effects.
Nelson
Aaron
A
Tufts University, School of Medicine, Boston, Massachusetts, USA.
Hartl
Wolfgang
W
Jauch
Karl-Walter
KW
Fricchione
Gregory L
GL
Benson
Herbert
H
Warshaw
Andrew L
AL
Conrad
Claudius
C
D016638:Critical Illness / Q000628:therapy*; D016207:Cytokines / Q000097:blood; D004734:Energy Metabolism / Q000502:physiology*; D006706:Homeostasis; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D009147:Music Therapy / Q000379:methods*; D015213:Neuroimmunomodulation / Q000502:physiology; D010913:Pituitary-Adrenal System / Q000502:physiology*
D016207:Cytokines; D019382:Human Growth Hormone; D006854:Hydrocortisone