- Design
- Single-blind randomised controlled trial
- Population
- 110 sedated, mechanically ventilated adults in one Spanish ICU
- Primary outcome
- Change in serum cortisol after a 60-minute session
- Effect
- Adjusted β −1.67 μg/dL (95% CI −2.90 to −0.44) vs standard care
A single-blind trial at a Spanish tertiary hospital randomised 110 sedated adults on invasive ventilation (bispectral index 40 to 60) to a 60-minute music session through noise-cancelling headphones or standard care.
Serum cortisol fell by 1.57 μg/dL after music and was essentially unchanged in controls; after adjustment, music was associated with cortisol about 1.67 μg/dL lower (95% CI −2.90 to −0.44). Heart rate, blood pressure and other physiological measures did not change.
Cortisol is a surrogate, measured once, straight after a single session. The trial says nothing about sedation needs, delirium or recovery. Music is cheap and appears harmless, which is reason enough to consider it, but not to expect clinical benefit on this evidence.
- Music through headphones is a low-cost, low-risk option for ventilated patients
- Do not expect reduced sedation or delirium on this evidence; only cortisol was measured
- Ask families about the patient's preferred music where possible
- Check skin under headphones in patients who cannot move or report discomfort
Why it matters
It gives a measurable physiological signal for a cheap intervention often dismissed as soft.
Don't overread it
Cortisol is a surrogate; the trial did not show effects on sedation, delirium or outcomes.
The statistics, in plain English
A drop of about 1.6 μg/dL is small relative to the wide range of cortisol in critical illness. The confidence interval excludes no effect, but the outcome is a biomarker, not how patients fared.
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