Music therapy in addition to music listening for the prevention of delirium in mechanically ventilated patients.

Abstract

Introduction: Delirium in mechanically ventilated patients has resulted in prolonged intensive care unit (ICU) and ventilator stay and higher mortality. Research has shown that a bundle containing sedation awakening and spontaneous breathing trials, appropriate choice of sedatives, early mobilization, and family engagement was associated with a reduced rate of delirium. Music listening and music therapy have also been studied, showing promising results for anxiety and pain control, but have not been studied in terms of preventing delirium.

Methods: As part of a quality improvement project, we implemented a protocol of music listening and music therapy for mechanically ventilated patients. The rate of delirium, ICU and ventilator lengths of stay, and mortality were compared between groups (n = 17 protocol, n = 50 control).

Results: There were no statistically significant differences in demographic characteristics, severity of illness, medical comorbidities, or cumulative doses of sedating medications between the groups. The rate of delirium between groups was not statistically significantly different (11.8% vs 16%, P = 0.70). Severity of illness based on APACHE IV score was statistically associated with mortality (estimate coefficient 0.03, P = 0.015), and use of dexmedetomidine was statistically associated with prolonged ICU and ventilator lengths of stay.

Conclusion: The music therapy and music listening protocol did not show a reduction of the delirium rate for mechanically ventilated patients.