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Music listening interventions for children receiving mechanical ventilation: A mechanistic trial

对接受机械通气的儿童进行音乐聆听干预：一项机械试验

基本信息

批准号：
10525363
负责人：
Jessica Jarvis
金额：
$ 13.19万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-05 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10525363
关键词：
Acute Adrenal Glands Adult Affect Analgesics Area Artificial Heart Autonomic nervous system Biological Biological Markers Brain Caregivers Child Childhood Clinical Trials Credentialing Critical Care Critical Illness Critically ill children Cross-Over Trials Data Delirium Dopamine Electrocardiogram Elements Family Focus Groups Freezing Frequencies Funding Future Goals Graph Group Interviews Health Heart Rate Hour Hydrocortisone Hypothalamic structure Impaired cognition Impairment Inflammation Intensive Care Interleukin-6 Intervention Interview Intubation Knowledge Linear Regressions Measurement Measures Mechanical ventilation Mediating Mentored Patient-Oriented Research Career Development Award Mentorship Methods Modeling Monitor Music Narcotics Nonpharmacologic Therapy Outcome Pain Participant Pathway interactions Patients Pediatric Intensive Care Units Pediatrics Periodicity Personal Satisfaction Pharmaceutical Preparations Pharmacy facility Physical Medicine Physical Rehabilitation Physics Physiological Physiology Pilot Projects Pituitary Gland Post-Traumatic Stress Disorders Randomized Research Research Personnel Respiration Respiratory Failure Rewards Risk Safety Saliva Sampling Science Sedation procedure Series Stress Stressful Event Structure Swab Syndrome Testing Time Titrations Training United States National Institutes of Health Universities Variant aged base beta-Endorphin career career development clinical implementation cohort design dosage efficacy testing experience functional disability heart rate variability hypothalamic-pituitary-adrenal axis implementation barriers improved individual response medical schools multidisciplinary neurochemistry pain symptom pediatric patients preference prevent professor programs prospective research and development respiratory sedative skills sound standard of care stress symptom survivorship therapy development treatment as usual vibration

项目摘要

PROJECT SUMMARY/ABSTRACT Pediatric critical illness exposes children to painful and stressful experiences. High levels of stress and pain increase the risk for adverse acute health outcomes (e.g., delirium) and long-term functional impairment, known as Post-Intensive Care Syndrome in Pediatrics (PICS-p). Respiratory support with intubation and mechanical ventilation (MV) exacerbates a child's stress and pain, for which the standard of care includes narcotics and sedation medication. However, these medications increase the risk of delirium, posttraumatic stress disorder, and impaired cognition. My long-term career goal is to develop mechanistically-based, nonpharmacologic interventions to remediate PICS-p and improve survivorship for children and their families following pediatric critical illness. I am an Assistant Professor in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh School of Medicine. The training proposed for this K23 award period is crucial for me to successfully launch this program of research as an independent researcher. Listening to music to increase comfort (“music listening”) decreases stress and pain symptoms and related outcomes (e.g., medication use, heart rate) during MV in adults and there is emerging data on feasibility and preliminary efficacy for music listening during MV in pediatrics. However, the mechanisms through which music listening impacts stress and pain is unclear, which limits identifying the `active ingredient' of music listening interventions, resulting in significant variability in intervention components and delivery. These data would result in an optimized music listening intervention for testing in future trials. We hypothesize live music from certified music therapists of child preferred songs may be most efficacious in decreasing stress and pain among children receiving MV compared to recorded music or usual care, due to rhythmic entrainment (active ingredient) and modulated through the autonomic nervous system (primary mechanism). This proposed research uses a mechanistic design, a randomized crossover trial with three conditions to compare their effects on biomarkers of stress and pain across three conditions in children with respiratory failure: Live music listening provided by a music therapist, recorded music listening, and usual care. To fill crucial gaps in my expertise, I propose five training objectives: (1) gain skills in the identification and use of biomarkers in pediatric critical care clinical trials; (2) obtain training in stress and pain physiology; (3) develop expertise in PICS-p outcomes; (4) develop skills in conducting interventional clinical trials; and (5) cultivate practical skills in team science, study implementation, and management. I have assembled a multidisciplinary mentorship team of NIH-funded investigators with expertise in each of my training areas. Completion of the proposed training and research will result in a competitive R21 application to test an optimized music listening intervention to decrease stress and pain among pediatric patients receiving MV.

项目总结/文摘