The Use of Music for Neonates Post-Cardiac Surgery
Condition: Heart Defects, Congenital
MeSH terms: Heart Defects, Congenital; Congenital Abnormalities
Study type: Interventional

Summary: 
      The purpose of this study is to explore the feasibility of implementing nurse-led music
      therapy in a cohort of neonates admitted to the Cardiac Intensive Care Unit (CICU) post
      congenital heart surgery. In the proposed setting, the use of a standardized nurse-led music
      therapy protocol for post-operative neonates would build upon current successful nurse-led
      efforts to wean sedatives and opioid use for patients admitted to the CICU. The investigators
      believe data generated from this exploratory feasibility study may serve to further inform a
      larger study involving the use of music therapy in the cardiac intensive care.
    

Detailed description: 
      A predetermined recording of a music playlist meeting the properties of sedative music is
      being developed in consultation with a Boston Children's Hospital (BCH) music therapist.
      Properties of sedative music include soothing, stable, constant, and relatively unchanging,
      slow tempo and light rhythmic emphasis, constant volume and rhythm, lullaby style,
      repetitious and no separate melody for chorus/bridge. The music recorded for the neonates has
      been produced specifically for this study. In accordance with the recommendations for
      soothing music, BCH Music Therapists have recorded English nursery rhymes (Figure 1) in the
      key of C major at 60bpm with acoustic guitar and voice. The playlist will be stored on an
      Apple iPod Touch and will be delivered through a Bluetooth speaker that is positioned
      centrally (so that the sound input is received binaurally) at the subjects head or feet for a
      period of 20 minutes once during a 12-hour shift for 14 days or until mechanical ventilation
      has been discontinued, whichever is first.

      The literature supports a duration of up to 30 minutes of music therapy followed by at least
      30 minutes of silence, with a maximum of four hours per day. Music played for longer than 30
      minutes has the potential to be a source of over-stimulation/agitation. There is some
      evidence to suggest that playing music for long periods of time (two four-hour segments) has
      a negative effect. In addition, it seems reasonable and likely to assume that the neonate
      could have a period of 30 minutes when they will not require an intervention associated with
      post-operative care. The protocol will target a 20 minute playlist. This will allow for
      variation in the length of songs while ensuring that music will not be played for longer than
      30 minutes. There will be at least 30 minutes of quiet between music therapy session.
    

Intervention name(s): Music Therapy
Intervention type(s): Other
Intervention description(s): Standardized music playlist will be played centrally at the subjects head or feet for a period of 20 minutes once during a 12-hour shift for 14 days or until mechanical ventilation has been discontinued, whichever is first
Intervention model: Single Group Assignment
Intervention model description: To explore the feasibility of implementing standardized nurse-led music therapy for neonates post congenital heart surgery who are admitted to the cardiac intensive care unit.
To describe the safety of implementing standardized nurse-led music therapy in the CICU.
To gather data regarding sedation requirements of subjects during music therapy.
To describe the parents perspective regarding nurse-led music therapy in the CICU.
Masking: None (Open Label)
Primary purpose: Supportive Care