Musical interventions for comfort Care in Critically ill Children: A systematic review

Abstract

BACKGROUND: Evidence supporting the use of musical intervention in the PICU is still limited. This systematic review aims to examine the current literature on musical interventions for sedation, analgesia, and delirium in critically ill children. METHODS: A literature search was conducted using MEDLINE, PUBMED, Google Scholar, and EMBASE from inception until December 31, 2024, using relevant medical subject headings and specific search terms. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Strategy was followed for article selection. Two reviewers independently screened studies for eligibility. Risk of bias was assessed, and the quality of evidence was evaluated using the GRADE methodology. RESULTS: Seven studies were included in the final analysis (1 randomized crossover trial, 3 randomized controlled trials, and 3 pretest-posttest studies). Due to the risk of bias, heterogeneity, and small sample sizes, the overall quality of evidence was rated as low. The review found that musical intervention led to a decline in heart rate in 5 studies, reduced procedural pain in 2 studies, and increased comfort in 4 studies. No improvement in delirium scores was observed in one single-center pilot study. CONCLUSIONS: Although evidence is limited, musical intervention shows promise as a non-pharmacologic option for sedation and analgesia in critically ill children in the PICU. Further research is needed to explore its effects on pediatric delirium.