Paroxysmal sympathetic hyperactivity (PSH) is a frequent symptom after traumatic brain injury and concerns up to 30% of severely brain-injured patients. PSH is due to unbalanced autonomic nervous system activity, resulting in sympathetic surges causing hypertension, tachycardia, sweating and hypertonia. The affected patients suffer more pain, more cardiovascular distress, more infections and prolonged rehabilitation and mechanical ventilation; additionally it could lead to a worse outcome. Classical music was shown to reduce autonomic nervous system imbalance in healthy people and in many medical diseases. It could be a means to dampen sympathetic surges for brain-injured patients presenting with PSH, as well. Our study aims at demonstrating that early musical intervention, started with the weaning of sedation, can reduce both the prevalence and the severity of paroxysmal sympathetic hyperactivity in traumatic brain-injured patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
11
Patients wear headphones twice a day during 30 minutes, starting at the onset of desedation (Day 0) until day 21, but no music is provided (blank playlist): Sham
Service d'Anesthésie Réanimation- Hôpital de Hautepierre
Strasbourg, France
Paroxysmal Sympathetic Hyperactivity Assessment Measure [PSH-AM] (ranging from 0 to 29)
The PSH-AM combines the sum of Clinical Features Scale \[CFS\] (from 0 to 18) and the Diagnostic Likelihood tool \[DLT\] (from 0 to 11)
Time frame: from desedation (Day 0) to Day 21.
Area under the Clinical Features Scale curve
Time frame: from Day 0 to Day 21.
Mean Analgesia Nociception Index
Time frame: from Day 0 to Day 21.
Neurological Pupil Index
Time frame: from Day 0 to Day 21.
Pain (Critical-Care Pain Observation Tool)
Time frame: from Day 0 to Day 21.
Neurological outcome (Wessex Head Injury Matrix)
Time frame: from Day 0 to Day 21.
PSH-AM
Time frame: Six and twelve months
Disability Rating Scale
Time frame: Six and twelve months
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