title: Music and biological stress dampening in mechanically-ventilated patients at the intensive care unit ward-a prospective interventional randomized crossover trial.
abstract: OBJECTIVE
  To evaluate the impact of slow-tempo music listening periods in mechanically ventilated intensive care unit patients.
  
  
  METHODS
  A randomized crossover study was performed in a 16-bed, adult critical care unit at a tertiary care hospital. Still-sedated patients, mandating at least 3 more days of mechanical ventilation, were included. The intervention consisted in two 1-hour daily periods of music-vs-sham-MP3 listening which were performed on Day 1 or 3 post-inclusion, with a Day 2 wash-out. "Before-after" collection of vital signs, recording of daily sedative drug consumption and measurement of stress and inflammatory blood markers were performed.
  
  
  RESULTS
  Of 55 randomized patients, 49 were included in the final analyses. Along with music listening, (i) vital signs did not consistently change, whereas narcotic consumption tended to decrease to a similar sedation (P = .06 vs sham-MP3); (ii) cortisol and prolactin blood concentrations decreased, whereas Adreno Cortico Trophic Hormone (ACTH)/cortisol ratio increased (P = .02; P = .038; and P = .015 vs sham-MP3, respectively), (iii) cortisol responders exhibited reversed associated changes in blood mehionine (MET)-enkephalin content (P = .01).
  
  
  CONCLUSIONS
  In the present trial, music listening is a more sensitive stress-reliever in terms of biological vs clinical response. The hypothalamus-pituitary adrenal axis stress axis is a quick sensor of music listening in responding mechanically ventilated intensive care unit patients, through a rapid reduction in blood cortisol.
authors.affiliation: Soins intensifs médicaux, département de Médecine, Université de Sherbrooke, Québec, Canada.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Beaulieu-Boire
authors.forename: Solange
authors.initials: S
authors.lastname: Bourque
authors.forename: Frederic
authors.initials: F
authors.lastname: Chagnon
authors.forename: Lucie
authors.initials: L
authors.lastname: Chouinard
authors.forename: Nicole
authors.initials: N
authors.lastname: Gallo-Payet
authors.forename: Olivier
authors.initials: O
authors.lastname: Lesur
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000701:Analgesics, Opioid / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D018592:Cross-Over Studies; D004744:Enkephalin, Methionine / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009146:Music; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012121:Respiration, Artificial; D013315:Stress, Psychological / Q000097:blood / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D015415:Biomarkers; D015850:Interleukin-6; D020738:Leptin; D004744:Enkephalin, Methionine; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D002097:C-Reactive Protein; D006854:Hydrocortisone
keywords: Biological markers; Cortisol; ICU; Music; Sedation; Stress