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Decreasing Delirium Through Music: A Randomized Pilot Trial.

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American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|March 2, 2020
PubMed
Summary

Music interventions are feasible and acceptable for intensive care unit patients. This study explored personalized music and slow-tempo music for delirium management, showing promise for non-pharmacological approaches.

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Area of Science:

  • Critical Care Medicine
  • Neuroscience
  • Psychology

Background:

  • Delirium management in intensive care units (ICUs) presents significant challenges due to a lack of effective therapies.
  • Music is recognized as a promising non-pharmacological intervention for managing critical care conditions.

Purpose of the Study:

  • To assess the feasibility and patient acceptability of personalized music (PM) and slow-tempo music (STM) compared to an attention control (AC) in mechanically ventilated ICU patients.
  • To estimate the impact of music interventions on delirium incidence and severity in the ICU setting.

Main Methods:

  • A randomized controlled trial was conducted in an academic medical-surgical ICU.
  • Patients were randomized to receive 1-hour sessions of PM, STM, or an audiobook (AC) twice daily for up to 7 days, utilizing noise-canceling headphones.
  • Delirium and its severity were assessed twice daily using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and CAM-ICU-7.

Main Results:

  • Recruitment involved 52 patients from 117 eligible individuals, with a monthly recruitment rate of 5 patients.
  • Adherence to music interventions was significantly higher (80% for PM and STM vs. 30% for AC; P = .01), and 80% of patients found the music enjoyable.
  • No statistically significant differences were observed in delirium/coma-free days (P = .32) or median delirium severity (P = .78) between the music groups and the attention control group by day 7.

Conclusions:

  • Music delivery via headphones is a feasible and acceptable intervention for patients in the intensive care unit setting.
  • While adherence and patient satisfaction were high, further research is warranted to definitively test music's efficacy in reducing ICU delirium.