While most studies in the medical literature that indicate "music" as an intervention may recognize its impact and capacity to decrease pain perception, anxiety, and/or its role in the regulation of cardiac and respiratory function in ICU patients, no identifiable studies have implemented entrained live music therapy protocols into clinical trials. Music therapy treatment is a non-pharmacological intervention that is individually tailored to the patient's needs and focuses on the assessment and intervention of a specific music application that is provided by a certified music therapist. Entrained music therapy focuses on a dynamic interaction between the patient and music therapist in which the music therapist attempts to promote relaxation and comfort through the patient's identified Song of Kin (SOK). This study measures the effects of live music therapy entrained to the vital signs of adult patients on duration of mechanical ventilation.
Adult patients with acute hypoxemic respiratory failure, acute hypercapnic respiratory failure, and ARDS admitted to the ICU requiring mechanical ventilation
Patients that are anticipated to remain on invasive mechanical ventilation for 48 hours or more will be screened for participation in the study
Under 18 years of age
Identified hearing disorder
Prior history of chronic respiratory failure requiring mechanical ventilation
RASS score of -4, or -5
Parallel
Toning
Other interventionMusic therapist will begin gentle breathing and toning on a descending "Ah" vowel to stimulate vibration in the chest and increase awareness of the breath. The patient will be encouraged to join the music therapist as is comfortable
Ocean drum & SOK melody
Other interventionMusic therapist will introduce ocean drum to mimic breathing sounds and will hum the melody of Song of Kin to begin entrainment process. Patient will be invited to join the music therapist in humming as is comfortable
SOK
Other interventionMusic therapist will introduce sung lyric content of Song of Kin accompanied on guitar. Patient will be invited to sing with music therapist as is comfortable.
Process
BehavioralMusic therapist will process patient experience and provide psycho-education on strategies for using music to promote comfort and enhance breath.
Holding Harmonic Container
Other interventionMusic therapist will provide a holding harmonic container of IM7 - IVM7 and will improvise a repeating melody on "ah" based on the ambient sounds in the patient's immediate environment
Cumulative Length of Time on Ventilator
Cumulative Length of Stay in Hospital
Respiration Rate
Heart Rate
Oxygen Saturation
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