title: Does music influence stress in mechanically ventilated patients?
abstract: OBJECTIVE
  Mechanically ventilated patients experience profound stress. Interventions are needed to ameliorate stress that does not cause adverse effects. The purpose of this study was to explore the influence of music on stress in a sample of patients over the duration of ventilatory support.
  
  
  METHODS
  Randomised controlled trial; randomised patients (56.8+16.9 years, 61% male, APACHE III 57.2+18.3) receiving ventilatory support to: (1) patient-directed music (PDM) where patients self-initiated music listening whenever desired from a preferred collection, (2) headphones only to block ICU noise, or (3) usual ICU care. Twenty-four hour urinary cortisol samples were collected from a sub-set of subjects with intact renal function and not receiving medications known to influence cortisol levels (n=65).
  
  
  METHODS
  12 ICUs in the Midwestern United States.
  
  
  METHODS
  Urinary free cortisol (UFC), an integrative biomarker of stress.
  
  
  RESULTS
  Controlling for illness severity, gender, and baseline UFC (29-45 mg/day), mixed models analysis revealed no significant differences among groups in UFC over the course of ventilatory support.
  
  
  CONCLUSIONS
  While music did not significantly reduce cortisol, less profound spikes in UFC levels were observed but that, given the limitations of the research, this observation could have occurred merely by chance.
authors.affiliation: School of Nursing, University of Minnesota, 5-160 Weaver-Densford Hall, 308 Harvard St. SE, Minneapolis, MN 55455, United States. chlan001@umn.edu
authors.forename: Linda L
authors.initials: LL
authors.lastname: Chlan
authors.forename: William C
authors.initials: WC
authors.lastname: Engeland
authors.forename: Kay
authors.initials: K
authors.lastname: Savik
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000628:therapy; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008297:Male; D008875:Middle Aged; D009147:Music Therapy; D012121:Respiration, Artificial / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*
chemical_list: D006854:Hydrocortisone