• Kirsten Deemer, Brittany Myhre, Stephanie Oviatt, Michelle Parsons, Mallory Watson, Karolina Zjadewicz, Andrea Soo, Kirsten Fiest, and Juan Posadas-Calleja.
• Department of Critical Care Medicine, Alberta Health Services, South Health Campus ICU, Office 150064, 4448 Front Street, Calgary, AB, T3M 1M4, Canada. kirsten.deemer@ahs.ca.
• Can J Anaesth. 2023 Jan 1; 70 (1): 139150139-150.

PurposeIntensive care unit (ICU) delirium is a common complication of critical illness requiring a multimodal approach to management. We assessed the feasibility of a novel occupational therapist (OT)-guided cognitive intervention protocol, titrated according to sedation level, in critically ill patients.MethodsPatients aged ≥ 18 yr admitted to a medical/surgical ICU were randomized to the standard delirium prevention protocol or to the OT-guided cognitive intervention protocol in addition to standard of care. The target enrolment number was N = 112. Due to the COVID-19 pandemic, the study enrolment period was truncated. The primary outcome was feasibility of the intervention as measured by the proportion of eligible cognitive interventions delivered by the OT. Secondary outcomes included feasibility of goal session length (20 min), participant clinical outcomes (delirium prevalence and duration, cognitive status, functional status, quality of life, and ICU length of stay), and a description of methodological challenges and solutions for future research.ResultsSeventy patients were enrolled and 69 patients were included in the final analysis. The majority of OT-guided sessions (110/137; 80%) were completed. The mean (standard deviation [SD]) number of sessions per patient was 4.1 (3.8). The goal session length was achieved (mean [SD], 19.8 [3.1] min), with few sessions (8/110; 7%) terminated early per patient request.ConclusionThis novel OT-guided cognitive intervention protocol is feasible in medical/surgical ICU patients. A larger randomized controlled trial is required to determine the impact of such a protocol on delirium prevalence or duration.Study Registrationwww.Clinicaltrialsgov (NCT03604809); registered 18 June 2018.© 2022. Canadian Anesthesiologists' Society.

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