Background Management of delirium in intensive care units is challenging because effective therapies are lacking. Music is a promising nonpharmacological intervention. Objectives To 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. Methods A 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. Results Of 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). Conclusions Music 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.
Background Post–intensive care syndrome is defined as the long-term cognitive, physical, and psychological impairments due to critical illness. Objective To validate the self-report version of the Healthy Aging Brain Care Monitor as a clinical tool for detecting post–intensive care syndrome. Methods A total of 142 patients who survived a stay in an intensive care unit completed the Healthy Aging Brain Care Monitor Self-report and standardized assessments of cognition, psychological symptoms, and physical functioning. Cronbach α was used to measure the internal consistency of the scale items. Validity between the Healthy Aging Brain Care Monitor and comparison tests was measured by using Spearman correlation coefficients. Patients with post–intensive care syndrome were compared with a sample of primary care patients (known groups validity) by using the Mann-Whitney test. General linear models were used to adjust for age, sex, and education level. Results The total scale and all subscales had good to excellent internal consistency (Cronbach α, 0.83-0.92). Scores on the psychological subscale strongly correlated with standardized measures of psychological symptoms (Spearman correlation coefficient, 0.68-0.74). Results on the cognitive subscale correlated with the delayed memory measure (−0.51). Scores on the physical subscale correlated with the Physical Self-Maintenance Scale (−0.26). Patients with post–intensive care syndrome had significantly worse scores on subscales and total scores on the Healthy Aging Brain Care Monitor than did primary care patients. Conclusion The self-report version of the Healthy Aging Brain Care Monitor is a valid clinical tool for assessing symptoms of post–intensive care syndrome.