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Acute Respiratory Distress SyndromeNCT03642002

The Effects of Music Therapy on Adult Patients Requiring Mechanical Ventilation in the ICU

A study testing Toning, Ocean drum & SOK melody and SOK in people with Acute Respiratory Distress Syndrome and Acute Hypoxemic Respiratory Failure, run by Icahn School of Medicine at Mount Sinai at 3 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Toning, Ocean drum & SOK melody and SOK
Could I receive a placebo?
No, everyone receives an active treatment
How many people
178 participants
Where
3 sitesUnited States
Study dates
12 Dec 2018to Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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

Who cannot join

  • Under 18 years of age
  • Identified hearing disorder
  • Prior history of chronic respiratory failure requiring mechanical ventilation
  • RASS score of -4, or -5
  • Active seizures, or status epilepticus
  • Cardiac arrest
Show all 9Show fewer
  • Coma
  • End of life
  • More than 2 vasopressors

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Joanne Loewy, DA, LCAT, MT-BC contact

(212) 420-3484

joanne.loewy@mountsinai.org

Christopher Pizzute, MA, LCAT-LP, MT-BC contact

(212) 636-3112

Christopher.Pizzute2@mountsinai.org

United States3 sites, 3 recruiting
  • Houston Methodist Hospital

    Houston, Texas, 77030

    Jennifer Townsend, Master of Music Therapy, 713-441-9231, jdtownsend@houstonmethodist.org

    Jennifer Townsend, Master of Music Therapy

    Recruiting
  • Houston Methodist Research Institute

    Houston, Texas, 77030

    Jennifer Townsend, 713-441-9231, jdtownsend@houstonmethodist.org

    Jennifer Townsend

    Recruiting
  • Mount Sinai West

    New York, New York, 10019

    Joanne Loewy, DA, LCAT, MT-BC, (212) 420-3484, joanne.loewy@mountsinai.org

    Christopher Pizzute, MA, LCAT-LP, MT-BC, (212) 636-3112, Christopher.Pizzute2@mountsinai.org

    Recruiting

Other trials in United States

About this study

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.

Read the detailed description

The study will include 178 adult patients on mechanical ventilation. These patients will be randomly assigned to the music therapy group or control group and matched for diagnosis, co-morbidities, age, and gender. The music therapy group will utilize a certified music therapist to provide live music based on the patient's cultural preferences and entrainment. The primary outcome is a reduction in mechanical ventilation hours of 35% compared to the control group. Secondary outcomes include: Amount of sedation, Richmond Agitation-Sedation Scale (RASS), delirium and pain score, ICU and hospital length of stay. The researchers hypothesize that live entrained music therapy compared to control will result in a reduction in the time of extubation, amount of sedation administered, ICU and hospital length of stay.

Being tested
Toning, Ocean drum & SOK melody, SOK, Process, Holding Harmonic Container
Keywords
music therapy, song of kin, music medicine
Medical subject headings
Respiratory Distress Syndrome, Respiratory Insufficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ToningOther

    Music 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 melodyOther

    Music 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

  • SOKOther

    Music 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.

  • ProcessBehavioural

    Music therapist will process patient experience and provide psycho-education on strategies for using music to promote comfort and enhance breath.

  • Holding Harmonic ContainerOther

    Music 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

Study groups in NCT03642002
Study groupRoleWhat they receive
ToningExperimentalVocal Tonal Holding
Receives: Other: Toning
Ocean drum & SOK melodyOtherOcean drum followed by melody of song of kin
Receives: Other: Ocean drum & SOK melody
SOKExperimentalSong of kin with lyric content
Receives: Other: SOK
ProcessExperimentalProcessing of experience
Receives: Behavioral: Process
Holding Harmonic ContainerExperimentalNot described
Receives: Other: Holding Harmonic Container

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Cumulative Length of Time on Ventilator

    Measured: average 14 days

Secondary outcomes (11)
  1. Cumulative Length of Stay in Hospital

    Measured: average 14 days

  2. Respiration Rate

    Measured: 15 minute intervals over 30 minute intervention

  3. Heart Rate

    Measured: 15 minute intervals over 30 minute intervention

  4. Oxygen Saturation

    Measured: 15 minute intervals over 30 minute intervention

  5. Amount of sedation

    Measured: 14 days

  6. Richmond Agitation-Sedation Scale (RASS)

    RASS is scored from +4 (combative) to -5 (unarousable), with lower score indicating more sedation.

    Measured: 14 days

  7. State-Trait Anxiety Inventory (STAI) (Short Form)

    To calculate the total STAI score (range 20-80):

    • Reverse scoring of the positive items (calm, relaxed, content) so 1=4, 2=3, 3=2, and 4=1;
    • Sum all six scores;
    • Multiply total score by 20/6
    • Scores are interpreted such that a "normal" score is approximately 24-36, Higher score indicates more anxiety

    Measured: 14 days

  8. Confusion Assessment Method for the ICU (CAM-ICU)

    CAM-ICU is a delirium monitoring instrument for ICU patients, scored for two possibilities: CAM-ICU Positive (where delirium is present for a patient) or CAM-ICU Negative (where delirium is not present for a patient).

    Measured: 14 days

  9. Pain score

    Numeric Pain Score (for enrollees able to speak). Pain score from 0 (no pain) to 10 (most pain)

    Measured: 14 days

  10. Wong-Baker FACES ® Pain Rating Scale

    Wong-Baker FACES ® Pain Rating Scale (for enrollees unable to speak). Pain score from 0 (no pain) to 10 (most pain)

    Measured: 14 days

  11. ICU length of stay

    Measured: average 14 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Aug 2018
  2. Study start12 Dec 2018
  3. Primary completionApr 2027 (estimated)
  4. Study completionDec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Outcomes Assessor will be unfamiliar with desired outcomes
Masking
None (open label)
Enrolment
178 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03642002
Sponsor's protocol ID
GCO 18-1079
Status last verified
Apr 2025
First submitted
15 Aug 2018
Last updated
9 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Chlan LL. Psychophysiologic responses of mechanically ventilated patients to music: a pilot study. Am J Crit Care. 1995 May;4(3):233-8.

    PubMed 7787918
  • Canga B, Azoulay R, Raskin J, Loewy J. AIR: Advances in Respiration - Music therapy in the treatment of chronic pulmonary disease. Respir Med. 2015 Dec;109(12):1532-9. doi: 10.1016/j.rmed.2015.10.001. Epub 2015 Oct 19.

    PubMed 26522499
  • Chlan L. Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung. 1998 May-Jun;27(3):169-76. doi: 10.1016/s0147-9563(98)90004-8.

    PubMed 9622403
  • Chlan LL. Music therapy as a nursing intervention for patients supported by mechanical ventilation. AACN Clin Issues. 2000 Feb;11(1):128-38. doi: 10.1097/00044067-200002000-00014.

    PubMed 11040559
  • Conti G, Mantz J, Longrois D, Tonner P. Sedation and weaning from mechanical ventilation: time for 'best practice' to catch up with new realities? Multidiscip Respir Med. 2014 Aug 29;9(1):45. doi: 10.1186/2049-6958-9-45. eCollection 2014.

    PubMed 25473522
  • Erdogan Z, Atik D. Complementary Health Approaches Used in the Intensive Care Unit. Holist Nurs Pract. 2017 Sep/Oct;31(5):325-342. doi: 10.1097/HNP.0000000000000227.

    PubMed 28786890
  • Hetland B, Lindquist R, Weinert CR, Peden-McAlpine C, Savik K, Chlan L. Predictive Associations of Music, Anxiety, and Sedative Exposure on Mechanical Ventilation Weaning Trials. Am J Crit Care. 2017 May;26(3):210-220. doi: 10.4037/ajcc2017468.

    PubMed 28461543
  • Hunter BC, Oliva R, Sahler OJ, Gaisser D, Salipante DM, Arezina CH. Music therapy as an adjunctive treatment in the management of stress for patients being weaned from mechanical ventilation. J Music Ther. 2010 Fall;47(3):198-219. doi: 10.1093/jmt/47.3.198.

    PubMed 21275332
  • Jaber S, Bahloul H, Guetin S, Chanques G, Sebbane M, Eledjam JJ. [Effects of music therapy in intensive care unit without sedation in weaning patients versus non-ventilated patients]. Ann Fr Anesth Reanim. 2007 Jan;26(1):30-8. doi: 10.1016/j.annfar.2006.09.002. Epub 2006 Nov 3. French.

    PubMed 17085009
  • Lee CH, Lee CY, Hsu MY, Lai CL, Sung YH, Lin CY, Lin LY. Effects of Music Intervention on State Anxiety and Physiological Indices in Patients Undergoing Mechanical Ventilation in the Intensive Care Unit. Biol Res Nurs. 2017 Mar;19(2):137-144. doi: 10.1177/1099800416669601. Epub 2016 Sep 21.

    PubMed 27655993
  • Loewy J, Stewart K, Dassler AM, Telsey A, Homel P. The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics. 2013 May;131(5):902-18. doi: 10.1542/peds.2012-1367. Epub 2013 Apr 15.

    PubMed 23589814
  • Loewy J, Hallan C, Friedman E, Martinez C. Sleep/sedation in children undergoing EEG testing: a comparison of chloral hydrate and music therapy. Am J Electroneurodiagnostic Technol. 2006 Dec;46(4):343-55.

    PubMed 17285817
  • Lindgren VA, Ames NJ. Caring for patients on mechanical ventilation: what research indicates is best practice. Am J Nurs. 2005 May;105(5):50-60; quiz 61. doi: 10.1097/00000446-200505000-00029. No abstract available.

    PubMed 15867534
  • Zilberberg MD, Shorr AF. Prolonged acute mechanical ventilation and hospital bed utilization in 2020 in the United States: implications for budgets, plant and personnel planning. BMC Health Serv Res. 2008 Nov 25;8:242. doi: 10.1186/1472-6963-8-242.

    PubMed 19032766
  • Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, Brummel NE, Hughes CG, Vasilevskis EE, Shintani AK, Moons KG, Geevarghese SK, Canonico A, Hopkins RO, Bernard GR, Dittus RS, Ely EW; BRAIN-ICU Study Investigators. Long-term cognitive impairment after critical illness. N Engl J Med. 2013 Oct 3;369(14):1306-16. doi: 10.1056/NEJMoa1301372.

    PubMed 24088092

Questions about this trial

What is this clinical trial studying?

A study testing Toning, Ocean drum & SOK melody and SOK in people with Acute Respiratory Distress Syndrome and Acute Hypoxemic Respiratory Failure, run by Icahn School of Medicine at Mount Sinai at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 9 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Joanne Loewy, DA, LCAT, MT-BC ((212) 420-3484, joanne.loewy@mountsinai.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Cumulative Length of Time on Ventilator (time frame: average 14 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03642002, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Apr 2025.

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