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[A randomized controlled trial on light music therapy for preventing intensive care unit delirium in patients
Xiaqin Liu1, Li'an Tang1, Caihong Wang2
1Departmet of Respiratory and Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Insights
Light music therapy significantly reduced delirium incidence in ICU patients on mechanical ventilation. This intervention also improved sedation and pain scores, shortened ventilation duration, and reduced ICU length of stay.
Area of Science:
- Critical Care Medicine
- Therapeutic Interventions
- Neuroscience
Background:
- Delirium is a common complication in intensive care unit (ICU) patients, particularly those on invasive mechanical ventilation.
- Preventing and managing delirium is crucial for improving patient outcomes and reducing healthcare costs.
- Non-pharmacological interventions are increasingly explored for their potential to mitigate delirium.
Purpose of the Study:
- To investigate the efficacy of light music therapy in reducing the incidence of delirium among ICU patients requiring invasive mechanical ventilation.
- To provide evidence-based support for the clinical application of music therapy in delirium prevention.
- To assess the impact of light music therapy on sedation levels, pain perception, mechanical ventilation duration, and ICU length of stay.
Main Methods:
- A prospective randomized controlled trial involving 140 ICU patients on invasive mechanical ventilation.
- Patients were randomized into an intervention group (routine care plus light music therapy) and a control group (routine care only).
- Delirium incidence was assessed using the Confusion Assessment Method-ICU (CAM-ICU) over 7 days. Richmond Agitation-Sedation Scale (RASS) and Critical Care Pain Observation Tool (CPOT) scores were also monitored.
Main Results:
- The incidence of delirium was significantly lower in the light music therapy group (27.7%) compared to the control group (51.6%).
- The intervention group showed significant improvements in RASS and CPOT scores, indicating better sedation and pain management.
- Light music therapy was associated with a significant reduction in mechanical ventilation duration and length of ICU stay.
Conclusions:
- Light music therapy is an effective intervention for reducing delirium incidence in mechanically ventilated ICU patients.
- The therapy positively impacts patient consciousness, pain perception, and sedation status.
- This non-pharmacological approach offers significant clinical value for delirium prevention and improving overall patient recovery in the ICU.
Objective:
To explore the effect of light music therapy on delirium in intensive care unit (ICU) patients undergoing invasive mechanical ventilation, and provide evidence-based support for clinical prevention of delirium.
Methods:
A prospective randomized controlled trial was conducted. 140 patients with invasive mechanical ventilation admitted to the department of respiratory and critical care medicine of First Affiliated Hospital of Guangxi Medical University from January 2024 to January 2025 were enrolled. The patients were divided into intervention group and control group using a random number table method. The control group received routine treatment and nursing care, while the intervention group received light music therapy three times a day for 30 minutes each time for 7 consecutive days. The confusion assessment method-ICU (CAM-ICU) was used to evaluate delirium, and the incidence of delirium within 7 days was statistically analyzed. Richmond agitation-sedation score (RASS), critical care pain observation tool (CPOT) score, mechanical ventilation duration, the length of ICU stay, and ICU stay expenses were record.
Results:
129 cases were ultimately included, including 64 cases in the control group and 65 cases in the intervention group. There was no statistically significant difference in baseline data between the two groups, indicating comparability. The incidence of delirium in the intervention group was significantly lower than that in the control group (27.7% vs. 51.6%, χ 2 = 7.687, P = 0.006). There was no significantly difference in RASS score between the two groups before enrollment (P = 0.840). After intervention, the RASS score in the intervention group significantly decreased, from 2.00 points on the 1st day of enrollment to 0.00 points on the 7th day, while the control group only decreased from 2.00 points to 1.50 points. The decreasing trend of the intervention group was more pronounced, especially on the 3rd day (P = 0.047) and the 7th day (P =0.005), with significant differences between the groups. The time effect (F = 18.929, P < 0.001), group effect (F = 6.655, P = 0.011), and time group interaction effect (F = 7.372, P < 0.001) of the two groups of RASS score were significant, suggesting that light music therapy has better timeliness and sustainability in improving patients' sedation status. There was no significantly difference in CPOT score between the two groups before enrollment (P = 0.902). After intervention, the CPOT score in the intervention group rapidly decreased from 3.00 points before enrollment to 1.00 points on the 1st day, and continued until the 7th day, while the control group showed a slower decrease from 2.50 points to 2.00 points and only dropped to 1.00 points on the 7th day. There were significant differences on 1st day and 3rd day between two groups (both P < 0.05). The time effect (F = 28.125, P < 0.001), group effect (F = 11.580, P = 0.001), and time group interaction effect (F = 4.048, P = 0.020) of the two groups of CPOT score were significant, indicating that light music therapy has better pain control, but the interaction effect is low, indicating that the impact of the intervention on the CPOT score was mainly concentrated in the early stage (1-3 days), and the long-term effect may be influenced by other factors. Compared with the control group, the intervention group showed a significant reduction in mechanical ventilation time (days: 10.57±2.94 vs. 11.95±3.74, P = 0.021) and the length of ICU stay (days: 14.91±4.37 vs. 17.53±4.83, P = 0.002). The ICU hospitalization expenses of the intervention group was slightly lower than that of the control group [ten thousand yuan: 22.431 (12.473, 28.489) vs. 29.362 (11.996, 41.389)], but the difference was not statistically significant (P = 0.086).
Conclusions:
Light music therapy can effectively reduce the incidence of delirium in patients undergoing invasive mechanical ventilation, improve consciousness and pain perception, shorten mechanical ventilation time and hospital stay, and has significant clinical promotion value high-quality studies.
