Hoosiers to Test a ‘Sound’ Hypothesis: Music Helps ICU Patients
Indianapolis ICU patients will listen to slow-tempo classical music for two one-hour sessions each day.
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Boosted by a $2 million grant, researchers at the Regenstrief Institute in Indianapolis will begin scientifically testing what many people instinctively know already: music just makes them feel better. It could also be an antidote to a dangerous brain condition in the Intensive Care Unit. Doctors noticed a disturbing trend among older patients in the ICU on mechanical ventilation: about 80% of them developed delirium, and tragically, it often changed their lives long after they were discharged. The researchers are confident Indianapolis ICU patients will soon prove what is somewhat unexplainable: music makes a difference.
Delirium is a sudden change in the brain that disrupts its normal functions, causing a patient to become confused, unable to pay attention and disoriented. More than 1 million adults annually in the U.S. are placed on a mechanical ventilator in the ICU; about 80% of them 65 and older develop the condition. Regenstrief Institute Research Scientist Dr. Babar Khan says ICU patients recovering from the flu, pneumonia or other conditions that cause fluid in the lungs often need mechanical ventilators to “breathe” for them.
Clinicians initially thought delirium was only a temporary condition, but then noticed an ominous pattern: patients that developed delirium were more likely to be discharged to nursing homes or rehabilitation facilities instead of going home, and they had higher mortality rates.
“The most devastating consequence of delirium when I think about it, is the people who survive the ICU and get discharged…have brain functions which are similar to patients with Alzheimer’s dementia,” says Khan, who leads an ICU survivorship clinic. “So we found delirium was associated with developing dementia-like symptoms after discharge from the ICU.”
Khan says, “Like all physicians, we started trying to take care of delirium by just drugs; trying to find a medicine that can cure it.” But drug trials showed the meds weren’t curing the delirium and caused other side effects. Intrigued by existing studies that showed music decreased anxiety in the ICU, the researchers believe music could reduce delirium too.
Supported by a $1.96 million grant from the National Institutes of Health, the study will enroll patients to test the theory at Eskenazi Health and Indiana University Health hospitals. Half of the 160 participants will wear noise-cancelling headphones to listen to slow-tempo classical music for two one-hour sessions each day; the other half will only wear the noise-cancelling headphones for the same time period. The team believes the three-and-a-half year study, in partnership with the Mayo Clinic, could open the door to an inexpensive, accessible and easily-implemented antidote to delirium.
“One of the great things about Regenstrief is the advances in science that happen here do not stay on a bookshelf,” says Khan, who is the study’s co-principal investigator. “As soon as the results are analyzed—and the hope is we will show positive results—then we’ll be able to…implement it in a clinical setting. We’ve done implementation work before, so we’re pretty confident…we’ll be able to implement it on a large scale at Eskenazi and IU Health immediately.”
Khan notes positive results could spark the use of music throughout the U.S. and even the world. While the study focuses on older adults because they have the highest risk of experiencing delirium, Khan says “it would be better to implement it for everybody.”
“If we can reduce problems with cognition or dementia-like symptoms, patients can get back to their lives and be productive members of society, as they were before being in the ICU,” says Khan. “Why would we let the ICU define the rest of the trajectory of their lives? If we can bend that trajectory and get people back to their lives, I think that would be a big win.”
Khan says “a critical mass” of Regenstrief scientists is leading the way in aging research.
Khan says the study could shine a light on the untapped therapeutic properties of music.
Khan says a unique strength at Regenstrief is reducing the time between discovery and implementation in the clinic.