PC3097: Use of Mindful Meditation in Critically Ill Children: A Pilot Feasibility Study

Background: Critical illness, particularly respiratory failure necessitating intubation and mechanical ventilation or non-invasive positive pressure ventilation can cause severe distress to pediatric patients, already at high risk for developing delirium and post-traumatic stress. Mindful meditation is a non-pharmacologic intervention that may benefit pediatric patients during critical illness from respiratory failure.

Methods: A prospective feasibility cohort study conducted in the pediatric ICU at Comer Children’s Hospital at the University of Chicago. Eligible patients include interactive children ages 5 to 18 years who receive either invasive positive pressure ventilation via endotracheal tube or noninvasive positive pressure ventilation via BiPAP or high flow nasal cannula. Patients receive a daily 5-to-7-minute orienting mindful meditation, through headphones, pre-recorded by a meditation expert specifically for pediatric patients during time spent in respiratory failure.

Results: 50 patients underwent mindful meditation for a total of 125 events. One patient did not tolerate the headphones and did not complete the event and was removed from data analysis. Nurses did not feel like the meditation event interfered with their job duties for any of the meditation events. Nurses agreed or strongly agreed that there was less need for nursing intervention during the session 58.8% of the time (n=67). Nurses agreed or strongly agreed that the meditation appeared to help reduce stress for the patient 94.7% of the time (n=108), and nurses felt that meditation exercises were useful for their patients 100% of the time (n=114). Parents agreed or strongly agreed that their child appeared less anxious during the mindfulness sessions 100% of the time (n=44). Parents did not feel that the meditation events interfered with medical care 100% of the time and felt that the activity helped to reduce stress for their child 97.7% of the time (n=43). No parent felt that the exercise disturbed their child during the hospital stay. 93.6% of the patients (n=44) stated that they liked listening to the recording. Patients reported that the recording helped them feel less scared or anxious 87.2% of the time (n=41) and patients felt that the recording helped them feel less pain 61.7% of the time (n=29). There were no adverse events.
There was an average decrease in heart rate of 4.3% and 7.2% halfway and the end of the event, respectively. There was an average decrease in respiratory rate by 11.1% and 19.4% halfway and at the end, respectively. Cerebral near infrared spectroscopy increased on average by 7.3%.

Conclusion: This pilot study shows that a mindful meditation intervention is feasible and safely tolerated for critically ill children with respiratory failure admitted to the pediatric intensive care unit. It also suggests that meditation could be beneficial to patients as measured by objective variables.