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Alaca A, Sarı HY, Yayla K. A scoping review of pain resulting from the endotracheal suctioning of paediatric intensive care patients. Int J Palliat Nurs 2024; 30:264-273. [PMID: 38913639 DOI: 10.12968/ijpn.2024.30.6.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND This scoping review was conducted to summarise and map studies on pain resulting from endotracheal suctioning in paediatric intensive care patients. METHOD This scoping review conducted in June 2022 was performed by screening articles published in English. Scopus, PubMed, Cochrane, Web of Science, MedLine and Ovid databases were used for screening. The keywords 'endotracheal suctioning', 'pain', 'paediatric intensive care' and their synonyms were used in the search. RESULTS During the review, 280 articles were accessed, and the full texts of 14 articles were evaluated for suitability. After some of the articles were excluded from the study, abstracts of nine articles were given below. CONCLUSION It is recommended that a greater number of randomised controlled studies should be conducted, because the number of studies with a high level of evidence on the effect of endotracheal suctioning on the pain levels of patients in the paediatric intensive care unit is very few.
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Affiliation(s)
- Aslı Alaca
- PhD student, Health Scıences Unıversıty; İzmir Tepecik Educatıon And Research Hospıtal
| | - Hatice Yıldırım Sarı
- Faculty of Health Science, Pediatric Nursing Department, Izmir Kâtip Çelebi University
| | - Kemal Yayla
- Information and Document Management, İzmir Kâtip Çelebi University, Faculty of Social Sciences and Humanities, İzmir, Turkey
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García-Fernández J, Romero-García M, Benito-Aracil L, Pilar Delgado-Hito M. Humanisation in paediatric intensive care units: A narrative review. Intensive Crit Care Nurs 2024:103725. [PMID: 38824005 DOI: 10.1016/j.iccn.2024.103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE To identify findings in the scientific literature relevant to the strategic lines proposed by the Humanising Intensive Care Project in the context of paediatric intensive care units. DESIGN Narrative review. METHODS A literature search was conducted in the databases PubMed, Scopus, CINHAL, and Cochrane Library. Specific indexing terms and search strategies adapted to each database were designed. The inclusion of publications was based on two criteria: 1) related to the paediatric intensive care unit and 2) addresses at least one of the topics related to the strategic lines of the Humanising Intensive Care Project. Study selection was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the quality of the included studies was assessed using the Mixed Method Appraisal tool. RESULTS A total of 100 articles from 19 different countries were included, covering the period between 2019 and 2021. Nineteen different design types were identified. Thirty-two studies were cross-sectional observational studies, while 15 had an experimental approach. The articles were distributed among the seven strategic lines of the Humanising Intensive Care Project. CONCLUSIONS Synthesising the knowledge related to humanisation in paediatric intensive care units will allow progress to be made in improving quality in these units. However, there is disparity in the amount of experimental research overall. IMPLICATIONS FOR CLINICAL PRACTICE There is a disparity in the available research related to the different strategic lines, and it is necessary to carry out more exhaustive research on topics such as the presence and participation of the family in care or the management of post-paediatric intensive care syndrome.
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Affiliation(s)
- Javier García-Fernández
- Multidisciplinary Nursing Research Group of the Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Marta Romero-García
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; GRIN-IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain; International Research Project for the Humanisation of Health Care, HU-CI Project: Humanising Intensive Care (HU-CI) Project, Collado Villalba, Madrid, Spain.
| | - Llúcia Benito-Aracil
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; GRIN-IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mª Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; GRIN-IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain; International Research Project for the Humanisation of Health Care, HU-CI Project: Humanising Intensive Care (HU-CI) Project, Collado Villalba, Madrid, Spain
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Mounier S, Cambonie G, Baleine J, Le Roux M, Bringuier S, Milési C. Music Therapy During Basic Daily Care in Critically Ill Children: A Randomized Crossover Clinical Trial. J Pediatr 2024; 264:113736. [PMID: 37722559 DOI: 10.1016/j.jpeds.2023.113736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/10/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To assess whether music therapy (MT) is effective to reduce pain during daily personal hygiene care (DPHC), a procedure performed in all patients in a pediatric intensive care unit. METHODS Fifty critically ill children were enrolled in a crossover controlled clinical trial with random ordering of the intervention, that is, passive MT, and standard conditions, and blind assessment of pain on film recordings. The primary outcome was variation of the Face Legs Activity Cry Consolability (FLACC) score (range, 0-10) comparing before and during DPHC. Secondary outcomes were changes in heart rate, respiratory rate, and mean arterial blood pressure, and administration of analgesic or sedative drugs during DPHC. Mixed-effects linear model analysis was used to assess effect size (95% CI). RESULTS The median (Q25-Q75) age and weight of the patients were 3.5 years (1.0-7.6 years) and 15.0 kg (10.0-26.8 kg). Consecutive DPHC were assessed on days 3 (2-5) and 4 (3-7) of hospitalization. In standard conditions, FLACC score was 0.0 (0.0-3.0) at baseline and 3.0 (1.0-5.5) during DPHC. With MT, these values were, respectively, 0.0 (0.0-1.0) and 2.0 (0.5-4.0). Rates of FLACC scores of >4 during DPHC, which indicates severe pain, were 42% in standard conditions and 17% with MT (P = .013). Mixed-effects model analysis found smaller increases in FLACC scores (-0.54 [-1.08 to -0.01]; P = .04) and heart rate (-9.00; [-14.53; -3.40]; P = .001) with MT. CONCLUSIONS MT is effective to improve analgesia in critically ill children exposed to DPHC. TRIAL REGISTRATION This study was recorded (April 16, 2019) before patient recruitment on the National Library of Medicine registry (NCT03916835; https://clinicaltrials.gov/ct2/show/NCT03916835).
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Affiliation(s)
- Sophie Mounier
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Gilles Cambonie
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France; Pathogenesis and Control of Chronic Infection, INSERM UMR 1058, University of Montpellier, Montpellier, France.
| | - Julien Baleine
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Manon Le Roux
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Sophie Bringuier
- Department of Medical Statistics and Epidemiology, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Christophe Milési
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
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Thorn AC, Brown K, Tolland M, Read J. Pediatric staff and their perceptions of music therapy services. J Pediatr Nurs 2023; 73:e138-e145. [PMID: 37567856 DOI: 10.1016/j.pedn.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE To reveal the benefits, needs, and limitations of music therapy observed by clinical pediatric staff at a children's hospital in the United States of America. DESIGN AND METHODS Researchers developed an electronic 13-question survey and distributed the survey in the fall of 2022. Questions included demographics, Likert-type scale, and open-ended queries. Data was collected via Qualtrics and analyzed using descriptive statistics and content analysis. RESULTS A total of 83 pediatric staff completed the survey. Staff observed positive benefits, where the highest reported areas were opportunities for dealing with anxiety/stress (94.7%), opportunities for social interaction (93.3%), and quality of life (89.3%). Analysis of free-response questions suggest that staff expect expertise and a nuanced understanding of the needs of each of their clinical units. CONCLUSION Results suggest that staff possess an overall positive attitude toward music therapy in all settings served. Music therapists may be valuable for psychosocial and rehabilitative support to hospitalized children and their families. PRACTICE IMPLICATIONS Nursing staff may utilize music therapists to improve patient outcomes and reduce the negative effects of hospitalization.
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Affiliation(s)
| | - Kristin Brown
- Nemours Children's Hospital, Orlando, FL, United States.
| | | | - Jenna Read
- Nemours Children's Hospital, Orlando, FL, United States
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Mata Ferro M, Falcó Pegueroles A, Fernández Lorenzo R, Saz Roy MÁ, Rodríguez Forner O, Estrada Jurado CM, Bonet Julià N, Geli Benito C, Hernández Hernández R, Bosch Alcaraz A. The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study. Aust Crit Care 2023; 36:967-973. [PMID: 36868934 DOI: 10.1016/j.aucc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/29/2022] [Accepted: 01/07/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Music therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). AIM The aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. METHODS This was a quasi-experimental pretest-posttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. RESULTS Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0-21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n = 130). Significantly lower values were observed for heart rate (p = 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. CONCLUSIONS Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.
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Affiliation(s)
- María Mata Ferro
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Anna Falcó Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | | | | | | | | | - Alejandro Bosch Alcaraz
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain.
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Sinha A, Rubin S, Jarvis JM. Promoting Functional Recovery in Critically Ill Children. Pediatr Clin North Am 2023; 70:399-413. [PMID: 37121633 PMCID: PMC11113330 DOI: 10.1016/j.pcl.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Over two-thirds of pediatric critical illness survivors will experience functional impairments that persist after discharge, that is, post-intensive care syndrome in pediatrics (PICS-p). Risk factors include child and family characteristics, invasive procedures, and social determinants of health. Approaches to remediate PICS-p include early rehabilitation, minimizing sedation, psychosocial resources for caregivers, delivery of family-centered care, and longitudinal screening for PICS-p. Challenges include feasible and validated approaches to screening, and resources and coordination for multidisciplinary care. Next steps should include resources to identify and address adverse social determinants of health and examination of treatment efficacy and implementation equity.
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Affiliation(s)
- Amit Sinha
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 Fifth Avenue, Suite 910, Pittsburgh, PA 15213, USA
| | - Sarah Rubin
- Department of Critical Care Medicine, University of Pittsburgh, 4401 Penn Avenue, Faculty Pavilion, 2nd Floor, Pittsburgh, PA 15224, USA
| | - Jessica M Jarvis
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 Fifth Avenue, Suite 910, Pittsburgh, PA 15213, USA.
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Küçük Alemdar D, Bulut A, Yilmaz G. Impact of music therapy and hand massage in the pediatric intensive care unit on pain, fear and stress: Randomized controlled trial. J Pediatr Nurs 2023; 71:95-103. [PMID: 37230011 DOI: 10.1016/j.pedn.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE This study was performed with the aim of assessing the effect of music therapy and hand massage on pain, fear and stress among 12-18 year-old adolescents treated in the pediatric intensive care unit (PICU). DESIGN This study was a randomized controlled trial, with single-blind design. METHODS The adolescents were divided into groups with 33 receiving hand massage, 33 receiving music therapy and 33 in the control group. Collection of data used the Wong-Baker FACES (WB-FACES) Pain Rating Scale, Children's Fear Scale (CFS) and blood cortisol levels. FINDINGS In the study, adolescents in the music therapy group had lower mean points for WB-FACES before, during and after the procedure by a significant level compared to the control group (p < 0.05). Additionally, the CFS mean points before and during the procedure were lowest in the music therapy group, while the music therapy and massage groups were determined to have lower points by a significant level after the procedure compared to the control group (p < 0.05). However, when the mean cortisol levels of adolescents before the procedure and on the 1st and 2nd day after the procedure were compared, there was no significant difference between the groups (p > 0.05). CONCLUSIONS It was determined that hand massage and music therapy were more effective than standard care at reducing pain and fear levels during blood drawing among 12-18-year-old adolescents in the PICU. PRACTICE IMPLICATIONS Nurses may use music therapy and hand massage to manage fear and pain related to blood drawing in the PICU.
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Affiliation(s)
- Dilek Küçük Alemdar
- Ordu University, Faculty of Health Sciences, Department of Pediatrics Nursing Ordu,Turkey.
| | - Azime Bulut
- Giresun University, Faculty of Medicine, Department of Anesthesia and Reanimation, Giresun/Turkey
| | - Gamze Yilmaz
- Ağrı İbrahim Çeçek University, Faculty of Health Sciences, Department of Pediatrics Nursing Ağrı, Turkey
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Cousin VL, Colau H, Barcos-Munoz F, Rimensberger PC, Polito A. Parents’ Views with Music Therapy in the Pediatric Intensive Care Unit: A Retrospective Cohort Study. CHILDREN 2022; 9:children9070958. [PMID: 35883942 PMCID: PMC9317819 DOI: 10.3390/children9070958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022]
Abstract
Purpose: Music therapy intervention (MT) could be used as an adjunctive therapy in PICU for anxiety and pain management. The aim of the study was to examine the perception of MT by children’s parents in a PICU of a tertiary care teaching hospital. Methods: This is a retrospective cohort study summarizing the results of an institutional quality improvement initiative. Questionnaires were distributed to parents whose children were exposed to MT. Results: From April 2019 to July 2021, 263 patients received a total of 603 h of MT. Twenty-five questionnaires were distributed to parents over a 4-month period (February–June 2021). A total of 19 (76%) parents completed the questionnaire. The majority of parents thought that MT helped their child to communicate (89%), feel less isolated (100%) and cope with stress during hospitalization (100%). The majority of parents also thought that MT contributed to physical recovery (90%) and alleviated feelings of anxiety (90%). Parents also believed that MT should be offered as an out-patient service. Conclusions: Our study agrees with other studies on the positive potentials of MT in PICU. Music therapy intervention could be used to promote children’s and parents’ psychological well-being. Further studies are warranted to evaluate the impact of MT on long-term post-ICU outcomes.
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Kudchadkar SR, Berger J, Patel R, Barnes S, Twose C, Walker T, Mitchell R, Song J, Anton B, Punjabi NM. Non-pharmacological interventions for sleep promotion in hospitalized children. Cochrane Database Syst Rev 2022; 6:CD012908. [PMID: 35703367 PMCID: PMC9199068 DOI: 10.1002/14651858.cd012908.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Healthy sleep is an important component of childhood development. Changes in sleep architecture, including sleep stage composition, quantity, and quality from infancy to adolescence are a reflection of neurologic maturation. Hospital admission for acute illness introduces modifiable risk factors for sleep disruption that may negatively affect active brain development during a period of illness and recovery. Thus, it is important to examine non-pharmacologic interventions for sleep promotion in the pediatric inpatient setting. OBJECTIVES To evaluate the effect of non-pharmacological sleep promotion interventions in hospitalized children and adolescents on sleep quality and sleep duration, child or parent satisfaction, cost-effectiveness, delirium incidence, length of mechanical ventilation, length of stay, and mortality. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, three other databases, and three trials registers to December 2021. We searched Google Scholar, and two websites, handsearched conference abstracts, and checked reference lists of included studies. SELECTION CRITERIA Randomized controlled trials (RCTs) or quasi-RCTs, including cross-over trials, investigating the effects of any non-pharmacological sleep promotion intervention on the sleep quality or sleep duration (or both) of children aged 1 month to 18 years in the pediatric inpatient setting (intensive care unit [ICU] or general ward setting). DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility, evaluated risk of bias, extracted and synthesized data, and used the GRADE approach to assess certainty of evidence. The primary outcomes were changes in both objective and subjective validated measures of sleep in children; secondary outcomes were child and parent satisfaction, cost-effectiveness ratios, delirium incidence or delirium-free days at time of hospital discharge, duration of mechanical ventilation, length of hospital stay, and mortality. MAIN RESULTS We included 10 trials (528 participants; aged 3 to 22 years) in inpatient pediatric settings. Seven studies were conducted in the USA, two in Canada, and one in Brazil. Eight studies were funded by government, charity, or foundation grants. Two provided no information on funding. Eight studies investigated behavioral interventions (massage, touch therapy, and bedtime stories); two investigated physical activity interventions. Duration and timing of interventions varied widely. All studies were at high risk of performance bias due to the nature of the intervention, as participants, parents, and staff could not be masked to group assignment. We were unable to perform a quantitative synthesis due to substantial clinical heterogeneity. Behavioral interventions versus usual care Five studies (145 participants) provided low-certainty evidence of no clear difference between multicomponent relaxation interventions and usual care on objective sleep measures. Overall, evidence from single studies found no clear differences in daytime or nighttime sleep measures (33 participants); any sleep parameter (48 participants); or daytime or nighttime sleep or nighttime arousals (20 participants). One study (34 participants) reported no effect of massage on nighttime sleep, sleep efficiency (SE), wake after sleep onset (WASO), or total sleep time (TST) in adolescents with cancer. Evidence from a cross-over study in 10 children with burns suggested touch therapy may increase TST (391 minutes, interquartile range [IQR] 251 to 467 versus 331 minutes, IQR 268 to 373; P = 0.02); SE (76, IQR 53 to 90 versus 66, IQR 55 to 78; P = 0.04); and the number of rapid eye movement (REM) periods (4.5, IQR 2 to 5 versus 3.5, IQR 2 to 4; P = 0.03); but not WASO, sleep latency (SL), total duration of REM, or per cent of slow wave sleep. Four studies (232 participants) provided very low-certainty evidence on subjective measures of sleep. Evidence from single studies found that sleep efficiency may increase, and the percentage of nighttime wakefulness may decrease more over a five-day period following a massage than usual care (72 participants). One study (48 participants) reported an improvement in Children's Sleep Habits Questionnaire scores after discharge in children who received a multicomponent relaxation intervention compared to usual care. In another study, mean sleep duration per sleep episode was longer (23 minutes versus 15 minutes), and time to fall asleep was shorter (22 minutes versus 27 minutes) following a bedtime story versus no story (18 participants); and children listening to a parent-recorded story had longer SL than when a parent was present (mean 57.5 versus 43.5 minutes); both groups reported longer SL than groups who had a stranger-recorded story, and those who had no story and absent parents (94 participants; P < 0.001). In one study (34 participants), 87% (13/15) of participants felt they slept better following massage, with most parents (92%; 11/12) reporting they wanted their child to receive a massage again. Another study (20 participants) reported that parents thought the music, touch, and reading components of the intervention were acceptable, feasible, and had positive effects on their children (very low-certainty evidence). Physical activity interventions versus usual care One study (29 participants) found that an enhanced physical activity intervention may result in little or no improvement in TST or SE compared to usual care (low-certainty evidence). Another study (139 participants), comparing play versus no play found inconsistent results on subjective measures of sleep across different ages (TST was 49% higher for the no play groups in 4- to 7-year olds, 10% higher in 7- to 11-year olds, and 22% higher in 11- to 14-year olds). This study also found inconsistent results between boys and girls (girls in the first two age groups in the play group slept more than the no play group). No study evaluated child or parent satisfaction for behavioral interventions, or cost-effectiveness, delirium incidence or delirium-free days at hospital discharge, length of mechanical ventilation, length of hospital stay, or mortality for either behavioral or physical activity intervention. AUTHORS' CONCLUSIONS The included studies were heterogeneous, so we could not quantitatively synthesize the results. Our narrative summary found inconsistent, low to very low-certainty evidence. Therefore, we are unable to determine how non-pharmacologic sleep promotion interventions affect sleep quality or sleep duration compared with usual care or other interventions. The evidence base should be strengthened through design and conduct of randomized trials, which use validated and highly reliable sleep assessment tools, including objective measures, such as polysomnography and actigraphy.
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Affiliation(s)
- Sapna R Kudchadkar
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jessica Berger
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ruchit Patel
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean Barnes
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Claire Twose
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tracie Walker
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Riley Mitchell
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jaehyun Song
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Blair Anton
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Naresh M Punjabi
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
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Buzzi F, Yahya NB, Gambazza S, Binda F, Galazzi A, Ferrari A, Crespan S, Al-Atroushy HA, Cantoni BM, Laquintana D. Use of Musical Intervention in the Pediatric Intensive Care Unit of a Developing Country: A Pilot Pre–Post Study. CHILDREN 2022; 9:children9040455. [PMID: 35455499 PMCID: PMC9032317 DOI: 10.3390/children9040455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/28/2022]
Abstract
Music is frequently used in different clinical settings, and it is implemented as a complementary, low-cost and useful intervention to reduce pain, anxiety and to improve relaxation. This pilot pre–post study aimed to examine the feasibility and preliminary effectiveness of a specific musical intervention in patients ≤16 years admitted to the Pediatric Intensive Care Unit (PICU) of an Iraqi hospital. The COMFORT Behavior Scale (CBS) was used by nurses to assess the level of sedation. Fifty-nine children were enrolled during the study period (March 2020–August 2021). CBS was lowered by 2.2 (95% CI: 1.9 to 2.6) points after 30 min, and by 3.3 (95% CI: 2.9 to 3.6) points after 60 min from music initiation. Thirty minutes after music initiation, heart rate decreased by 6.3 (95% CI: 4.5 to 8.1) beats per minute, whereas at 60 min, heart rate decreased by 9.1 (95% CI: 7.2 to 10.9) beats per minute. No clinically significant variations were detected in the other vital signs (blood pressure, respiratory rate and oxygen saturation). These findings support the feasibility of musical intervention in a developing country. CBS and heart rate variation may be worth following up in larger and conclusive studies.
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Affiliation(s)
- Federica Buzzi
- Pediatric Unit, Istituto Scientifico, Universitario San Raffaele, 20132 Milan, Italy;
- EU Project MADAD, Italian Association for Solidarity among Peoples, Duhok 42001, Iraq
| | - Nizar Bakir Yahya
- Hospital Direction, Hevi Pediatric Teaching Hospital, Duhok 42001, Iraq;
| | - Simone Gambazza
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.G.); (F.B.); (B.M.C.); (D.L.)
| | - Filippo Binda
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.G.); (F.B.); (B.M.C.); (D.L.)
| | - Alessandro Galazzi
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.G.); (F.B.); (B.M.C.); (D.L.)
- Correspondence: ; Tel.: +39-02-5503-3107
| | | | - Stefano Crespan
- Curadelsuono432 Project, 30020 Venice, Italy; (A.F.); (S.C.)
| | | | - Barbara Maria Cantoni
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.G.); (F.B.); (B.M.C.); (D.L.)
| | - Dario Laquintana
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.G.); (F.B.); (B.M.C.); (D.L.)
| | - Collaborative Group
- Pediatric Intensive Care Unit, Hevi Pediatric Teaching Hospital, Duhok 42001, Iraq;
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11
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babaie S, torki A, Keivanfar M. Efficacy of fentanyl on pain relief during tracheal suctioning in ventilated children: A randomized clinical trial. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2021. [DOI: 10.1016/j.tacc.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Huang YL, Lei YQ, Xie WP, Cao H, Yu XR, Chen Q. Effect of music therapy on infants who underwent mechanical ventilation after cardiac surgery. J Card Surg 2021; 36:4460-4464. [PMID: 34477246 DOI: 10.1111/jocs.15976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/17/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the effect of music therapy on infants who underwent mechanical ventilation after cardiac surgery. METHODS A prospective randomized controlled study was conducted in a provincial hospital in southeast China. The subjects were randomly divided into the music therapy (MT) group and the control group. Both groups were given standardized sedation treatment and routine nursing. Infants in the MT group received 60 min of MT three times a day. The sedation medication, Richmond sedation agitation scale (RASS) score, incidence of delirium, mechanical ventilation duration, length of cardiac intensive care unit (CICU) stay, restraint belt use time, and successful ventilation withdrawal rate were collected. RESULTS Infants in the control group had a higher total amount of on-demand midazolam (p = .039). Infants in the MT group had a significantly lower incidence of delirium, shorter mechanical ventilation duration, and restraint band use time (p = .047, p = .046, and p = .038, respectively). Although infants in the MT group had a higher success rate of ventilation withdrawal, lower RASS scores, and shorter ICU stay, the difference was not statistically significant (p = .427, p = .585, and p = .068, respectively). CONCLUSION MT in the ICU can reduce the use of on-demand sedative drugs, shorten mechanical ventilation, and reduce the occurrence of delirium in infants who underwent mechanical ventilation after cardiac surgery. MT is a safe and reliable treatment and worthy of clinical application.
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Affiliation(s)
- Ya-Li Huang
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Yu-Qing Lei
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Wen-Peng Xie
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Xian-Rong Yu
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.,Fujian Children's Hospital, Fuzhou, China.,Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
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13
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Idrobo-Ávila E, Loaiza-Correa H, Muñoz-Bolaños F, van Noorden L, Vargas-Cañas R. A Proposal for a Data-Driven Approach to the Influence of Music on Heart Dynamics. Front Cardiovasc Med 2021; 8:699145. [PMID: 34490368 PMCID: PMC8417899 DOI: 10.3389/fcvm.2021.699145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
Electrocardiographic signals (ECG) and heart rate viability measurements (HRV) provide information in a range of specialist fields, extending to musical perception. The ECG signal records heart electrical activity, while HRV reflects the state or condition of the autonomic nervous system. HRV has been studied as a marker of diverse psychological and physical diseases including coronary heart disease, myocardial infarction, and stroke. HRV has also been used to observe the effects of medicines, the impact of exercise and the analysis of emotional responses and evaluation of effects of various quantifiable elements of sound and music on the human body. Variations in blood pressure, levels of stress or anxiety, subjective sensations and even changes in emotions constitute multiple aspects that may well-react or respond to musical stimuli. Although both ECG and HRV continue to feature extensively in research in health and perception, methodologies vary substantially. This makes it difficult to compare studies, with researchers making recommendations to improve experiment planning and the analysis and reporting of data. The present work provides a methodological framework to examine the effect of sound on ECG and HRV with the aim of associating musical structures and noise to the signals by means of artificial intelligence (AI); it first presents a way to select experimental study subjects in light of the research aims and then offers possibilities for selecting and producing suitable sound stimuli; once sounds have been selected, a guide is proposed for optimal experimental design. Finally, a framework is introduced for analysis of data and signals, based on both conventional as well as data-driven AI tools. AI is able to study big data at a single stroke, can be applied to different types of data, and is capable of generalisation and so is considered the main tool in the analysis.
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Affiliation(s)
- Ennio Idrobo-Ávila
- Escuela de Ingeniería Eléctrica y Electrónica, PSI - Percepción y Sistemas Inteligentes, Universidad del Valle, Cali, Colombia
| | - Humberto Loaiza-Correa
- Escuela de Ingeniería Eléctrica y Electrónica, PSI - Percepción y Sistemas Inteligentes, Universidad del Valle, Cali, Colombia
| | - Flavio Muñoz-Bolaños
- Departamento de Ciencias Fisiológicas, CIFIEX - Ciencias Fisiológicas Experimentales, Universidad del Cauca, Popayán, Colombia
| | - Leon van Noorden
- Department of Art, Music, and Theatre Sciences, IPEM—Institute for Systematic Musicology, Ghent University, Ghent, Belgium
| | - Rubiel Vargas-Cañas
- Departamento de Física, SIDICO - Sistemas Dinámicos, Instrumentación y Control, Universidad del Cauca, Popayán, Colombia
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14
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Yang JX, Yao WY, Wang X, Sheng M, Zhang WY, Bai ZJ, Ling S. Development of a Chinese Version of the State Behavioral Scale for Mechanically Ventilated Children. J Pediatr Nurs 2021; 58:e13-e18. [PMID: 33384221 DOI: 10.1016/j.pedn.2020.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To develop a Chinese version of the State Behavioral Scale (SBS-C) and to evaluate its reliability and validity for sedation assessment in mechanically ventilated children in China. DESIGN AND METHODS Cross-sectional survey design was used in a two-part study of mechanically ventilated children, aged 6 weeks to 6 years. A total 172 children and 145 children were recruited from Jan-Dec 2017 and Jan-Dec 2018, respectively, at a tertiary care pediatric hospital in southeast China. Following translation of the scale, the content validity was established by the content validity index, internal consistency was established using Cronbach's α, and construct validity was confirmed by correlation with a similar well-recognized scale, the COMFORT Scale-Chinese version (CS-C). RESULTS The content validity index for the seven scale dimensions ranged from 0.83 to 1.0 and for the full scale was 0.932. In the first study, Cronbach's α for the full SBS-C was 0.986 and for the seven scale dimensions ranged from 0.973 to 0.983; similarly, in the second study, Cronbach's α for the full scale was 0.983 and for the seven dimensions ranged from 0.977 to 0.987. The correlation coefficient between scores of the SBS-C and the CS-C was 0.919 (P < .01). CONCLUSIONS The SBS-C is valid, reliable, and responsive and is suitable for assessing sedation in mechanically ventilated children in China. IMPLICATIONS FOR PRACTICE The SBS-C can be used for sedation assessment in mechanically ventilated children in China, guiding decision making and the provision of care, and optimizing patient safety.
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Affiliation(s)
- Jin-Xia Yang
- Intensive Care Unit, Department of Nursing, Children's Hospital of Soochow University, China
| | - Wen-Ying Yao
- Department of Nursing, Children's Hospital of Soochow University, Suzhou 215025, China.
| | - Xin Wang
- Department of Nursing, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Min Sheng
- Department of Nursing, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Wen-Yan Zhang
- Intensive Care Unit, Department of Nursing, Children's Hospital of Soochow University, China
| | - Zhen-Jiang Bai
- Intensive Care Unit, Department of Medicine, Children's Hospital of Soochow University, China
| | - Sh Ling
- Intensive Care Unit, Department of Nursing, Children's Hospital of Soochow University, China
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15
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Garcia Guerra G, Joffe AR, Sheppard C, Hewson K, Dinu IA, Hajihosseini M, deCaen A, Jou H, Hartling L, Vohra S. Music Use for Sedation in Critically ill Children (MUSiCC trial): a pilot randomized controlled trial. J Intensive Care 2021; 9:7. [PMID: 33431051 PMCID: PMC7802123 DOI: 10.1186/s40560-020-00523-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/28/2020] [Indexed: 12/01/2022] Open
Abstract
Objective To demonstrate feasibility of a music medicine intervention trial in pediatric intensive care and to obtain information on sedation and analgesia dose variation to plan a larger trial. Material and methods Pilot randomized controlled trial (RCT) was conducted at the Stollery Children’s Hospital general and cardiac intensive care units (PICU/PCICU). The study included children 1 month to 16 years of age on mechanical ventilation and receiving sedation drugs. Patients were randomized in a 1:1:1 ratio to music, noise cancellation or control. The music group received classical music for 30 min three times/day using headphones. The noise cancellation group received the same intervention but with no music. The control group received usual care. Results A total of 60 patients were included. Average enrollment rate was 4.8 patients/month, with a consent rate of 69%. Protocol adherence was achieved with patients receiving > 80% of the interventions. Overall mean (SD) daily Sedation Intensity Score was 52.4 (30.3) with a mean (SD) sedation frequency of 9.75 (7.21) PRN doses per day. There was a small but statistically significant decrease in heart rate at the beginning of the music intervention. There were no study related adverse events. Eighty-eight percent of the parents thought the headphones were comfortable; 73% described their child more settled during the intervention. Conclusions This pilot RCT has demonstrated the feasibility of a music medicine intervention in critically ill children. The study has also provided the necessary information to plan a larger trial. Supplementary Information The online version contains supplementary material available at 10.1186/s40560-020-00523-7.
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Affiliation(s)
- Gonzalo Garcia Guerra
- Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada. .,Stollery Children's Hospital, Edmonton, AB, Canada.
| | - Ari R Joffe
- Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.,Stollery Children's Hospital, Edmonton, AB, Canada
| | | | - Krista Hewson
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - Irina A Dinu
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | | | - Allan deCaen
- Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.,Stollery Children's Hospital, Edmonton, AB, Canada
| | - Hsing Jou
- Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.,Stollery Children's Hospital, Edmonton, AB, Canada.,Integrative Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Sunita Vohra
- Department of Pediatrics, University of Alberta, Room 4-548 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.,Stollery Children's Hospital, Edmonton, AB, Canada.,Integrative Health Institute, University of Alberta, Edmonton, AB, Canada
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