Music Therapy During Pediatric Extubation Readiness Trials

The music therapy intervention offered during the time of the patient's extubation readiness
trial (ERT) will consist of live music using a multitude of instruments and patient-preferred
and improvised music. The start time and duration of the session will be initiated by the
attending physician, and the length of music therapy intervention provided will not exceed
two and a half hours. The music therapy intervention will continue for 30 minutes post
extubation. This time frame was determined in accordance with the institution's weaning trial
protocol. Family members involved in the trial, as well as the nurse and physician, will
complete a post-procedural survey about the music therapy intervention.

The music therapy interventions will always include the use of live music, including guitar,
keyboard, voice, ocean drum, reverie harp, and/or various percussive instruments. The music
therapist will use a tablet to understand how to play patient-preferred songs. To ensure
patient safety, the music therapist will adhere to the infection control policies set forth
by the institution. The following are the intended goals of the Music therapy intervention:
facilitating relaxation, alleviation of anxiety, and successful utilization of new coping
skills.

Before the weaning trial, the music therapist will meet with the patient's family to obtain
the musical preferences of the patient. During the two hour ERT, the music therapist will
play patient-preferred songs on a variety of different instruments to bring about a sense of
interpersonal connectedness, normalization, and to enhance adaptive coping. In order to
maximize coping and minimize stress/anxiety, the music therapy intervention will be malleable
and patient/family centered, responding to the changing needs that present throughout the
procedure/weaning process. If the patient becomes more alert throughout the weaning process,
the music therapist will adapt the music making based on patient's preferences; at this time,
the patient may be able to answer yes/no questions when asked. The music therapist will
adjust the volume, timbre, and tempo of the music according to the patient's respiratory
rhythms throughout the weaning process and after extubation.

When the live music therapy intervention has completed, the music therapist will follow up
with the family members immediately. The investigator will administer and collect the survey
from the family, and the music therapist will administer and collect the survey from the
nurse and physician.

Inclusion Criteria:

- Patients 0-18 years of age admitted to the pediatric intensive care unit, regardless
of cognitive status

- Patients admitted receiving endotracheal mechanical ventilation

Exclusion Criteria:

- Patients receiving extubation for withdrawal of care, patients with known/documented
hearing loss/deafness.

- Patients on mechanical ventilation not scheduled for planned ERT.