Research Article| Volume 47, ISSUE 5, P489-496, September 2018

Effects of music intervention on inflammatory markers in critically ill and post-operative patients: A systematic review of the literature



      Music listening has been shown to reduce anxiety, stress, and patient tolerance of procedures. Music may also have beneficial effects on inflammatory biomarkers in intensive care and post-operative patients, but the quality of evidence is not clear.


      We conducted a systematic review to evaluate the effects of music on inflammatory biomarkers in intensive care, and post-operative patients.


      A comprehensive search of the literature was performed. After screening 1570 references, full text review of 26 studies was performed. Fourteen studies were selected for inclusion.


      Seven studies showed a significant decrease in cortisol levels, but the level of evidence was low. Three studies had low risk of methodological bias, while 11 studies had high risk of bias.


      Music intervention may decrease cortisol levels, but other biomarkers remain unchanged. Given the low level of evidence, further research on music effects on inflammatory biomarkers is needed.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bradt J.
        • Dileo C.
        Music interventions for mechanically ventilated patients.
        Cochrane Database Syst Rev. 2014; (Cd006902)
        • Evans D.
        The effectiveness of music as an intervention for hospital patients: a systematic review.
        J Adv Nurs. 2002; 37: 8-18
        • Chlan L.L.
        • Weinert C.R.
        • Heiderscheit A.
        • et al.
        Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial.
        JAMA. 2013; 309: 2335-2344
        • Hetland B.
        • Lindquist R.
        • Chlan L.L.
        The influence of music during mechanical ventilation and weaning from mechanical ventilation: a review.
        Heart Lung. 2015; 44: 416-425
        • Vuilleumier P.
        • Trost W.
        Music and emotions: from enchantment to entrainment.
        Ann N Y Acad Sci. 2015; 1337: 212-222
        • Trost W.
        • Fruhholz S.
        • Schon D.
        • et al.
        Getting the beat: entrainment of brain activity by musical rhythm and pleasantness.
        Neuroimage. 2014; 103: 55-64
        • Okada K.
        • Kurita A.
        • Takase B.
        • et al.
        Effects of music therapy on autonomic nervous system activity, incidence of heart failure events, and plasma cytokine and catecholamine levels in elderly patients with cerebrovascular disease and dementia.
        Int Heart J. 2009; 50: 95-110
        • Chanda M.L.
        • Levitin D.J.
        The neurochemistry of music.
        Trends Cogn Sci. 2013; 17: 179-193
        • Fancourt D.
        • Ockelford A.
        • Belai A.
        The psychoneuroimmunological effects of music: a systematic review and a new model.
        Brain Behav Immun. 2014; 36: 15-26
        • Jadad A.R.
        • Moore R.A.
        • Carroll D.
        • et al.
        Assessing the quality of reports of randomized clinical trials: is blinding necessary?.
        Control Clin Trials. 1996; 17: 1-12
        • Jüni P.
        • Witschi A.
        • Bloch R.
        • Egger M.
        The hazards of scoring the quality of clinical trials for meta-analysis.
        JAMA. 1999; 282: 1054-1060
        • Higgins J.P.T.
        • Altman D.G.
        • Gøtzsche P.C.
        • et al.
        The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.
        BMJ. 2011; 343: d5928
        • Higgins J.P.T.
        • Green S.
        Cochrane handbook for systematic reviews of interventions version 5.1.0.
        • Group G.W.
        Grading quality of evidence and strength of recommendations.
        BMJ. 2004; 328: 1490
        • Beaulieu-Boire G.
        • Bourque S.
        • Chagnon F.
        • Chouinard L.
        • Gallo-Payet N.
        • Lesur O.
        Music and biological stress dampening in mechanically-ventilated patients at the intensive care unit ward-a prospective interventional randomized crossover trial.
        J Crit Care. 2013; 28: 442-450
        • Koelsch S.
        • Fuermetz J.
        • Sack U.
        • et al.
        Effects of music listening on cortisol levels and propofol consumption during spinal anesthesia.
        Front Psychol. 2011; 2: 58
        • Migneault B.
        • Girard F.
        • Albert C.
        • et al.
        The effect of music on the neurohormonal stress response to surgery under general anesthesia.
        Anesth Analg. 2004; 98: 527-532
        • Nilsson U.
        The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial.
        Heart Lung. 2009; 38: 201-207
        • Nilsson U.
        Soothing music can increase oxytocin levels during bed rest after open-heart surgery: a randomised control trial.
        J Clin Nurs. 2009; 18: 2153-2161
        • Chlan L.L.
        • Engeland W.C.
        • Anthony A.
        • Guttormson J.
        Influence of music on the stress response in patients receiving mechanical ventilatory support: a pilot study.
        Am J Crit Care. 2007; 16: 141-145
        • Chlan L.L.
        • Engeland W.C.
        • Savik K.
        Does music influence stress in mechanically ventilated patients?.
        Intensive Crit Care Nurs. 2013; 29: 121-127
        • Graversen M.
        • Sommer T.
        Perioperative music may reduce pain and fatigue in patients undergoing laparoscopic cholecystectomy.
        Acta Anaesthesiol Scand. 2013; 57: 1010-1016
        • Leardi S.
        • Pietroletti R.
        • Angeloni G.
        • Necozione S.
        • Ranalletta G.
        • Del Gusto B.
        Randomized clinical trial examining the effect of music therapy in stress response to day surgery.
        Br J Surg. 2007; 94: 943-947
        • Lee C.H.
        • Lee C.Y.
        • Hsu M.Y.
        • et al.
        Effects of music intervention on state anxiety and physiological indices in patients undergoing mechanical ventilation in the intensive care unit.
        Biol Res Nurs. 2017; 19: 137-144
        • Nilsson U.
        • Unosson M.
        • Rawal N.
        Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial.
        Eur J Anaesthesiol. 2005; 22: 96-102