• Am. J. Crit. Care · Mar 2020

    Randomized Controlled Trial

    Decreasing Delirium Through Music: A Randomized Pilot Trial.

    • Sikandar H Khan, Chenjia Xu, Russell Purpura, Sana Durrani, Heidi Lindroth, Sophia Wang, Sujuan Gao, Annie Heiderscheit, Linda Chlan, Malaz Boustani, and Babar A Khan.
    • Sikandar H. Khan is an assistant professor, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, and a scientist, Center for Aging Research, Indiana University, Indianapolis, Indiana.
    • Am. J. Crit. Care. 2020 Mar 1; 29 (2): e31-e38.

    BackgroundManagement of delirium in intensive care units is challenging because effective therapies are lacking. Music is a promising nonpharmacological intervention.ObjectivesTo determine the feasibility and acceptability of personalized music (PM), slow-tempo music (STM), and attention control (AC) in patients receiving mechanical ventilation in an intensive care unit, and to estimate the effect of music on delirium.MethodsA randomized controlled trial was performed in an academic medical-surgical intensive care unit. After particular inclusion and exclusion criteria were applied, patients were randomized to groups listening to PM, relaxing STM, or an audiobook (AC group). Sessions lasted 1 hour and were given twice daily for up to 7 days. Patients wore noise-canceling headphones and used mp3 players to listen to their music/audiobook. Delirium and delirium severity were assessed twice daily by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the CAM-ICU-7, respectively.ResultsOf the 1589 patients screened, 117 (7.4%) were eligible. Of those, 52 (44.4%) were randomized, with a recruitment rate of 5 patients per month. Adherence was higher in the groups listening to music (80% in the PM and STM groups vs 30% in the AC group; P = .01), and 80% of patients surveyed rated the music as enjoyable. The median number (interquartile range) of delirium/coma-free days by day 7 was 2 (1-6) for PM, 3 (1-6) for STM, and 2 (0-3) for AC (P = .32). Median delirium severity was 5.5 (1-7) for PM, 3.5 (0-7) for STM, and 4 (1-6.5) for AC (P = .78).ConclusionsMusic delivery is acceptable to patients and is feasible in intensive care units. Further research testing use of this promising intervention to reduce delirium is warranted.©2020 American Association of Critical-Care Nurses.

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