title: The impact of music on hypermetabolism in critical illness.
abstract: 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.
authors.affiliation: Tufts University, School of Medicine, Boston, Massachusetts, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Nelson
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartl
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Fricchione
authors.forename: Herbert
authors.initials: H
authors.lastname: Benson
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Warshaw
authors.forename: Claudius
authors.initials: C
authors.lastname: Conrad
mesh_terms: 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*
chemical_list: D016207:Cytokines; D019382:Human Growth Hormone; D006854:Hydrocortisone