Slow-Tempo Music and Delirium/Coma-Free Days Among Older Adults Undergoing Mechanical Ventilation

作者：Babar Khan, Sikandar Khan, Anthony J. Perkins, Annie Heiderscheit, Frederick W. Unverzagt, Sophia Wang, John B. Downs, Sujuan Gao, Linda L. Chlan · 发表于：JAMA Internal Medicine · 年份：2025 · DOI：10.1001/jamainternmed.2025.5263 · 被引用次数：7 · 研究领域：Intensive Care Unit Cognitive Disorders、Music Therapy and Health、Family and Patient Care in Intensive Care Units

Importance: An estimated 70% to 80% of older adults develop delirium in the intensive care unit (ICU). Objective: To determine if a slow-tempo music (60-80 beats/min) listening intervention decreases delirium duration, delirium severity, pain, or anxiety in older adults undergoing mechanical ventilation. Design, Setting, and Participants: This multicenter randomized clinical trial with concealed outcomes assessments was conducted in older adults undergoing mechanical ventilation from February 2020 to December 2023. Patients were enrolled from the ICUs of 2 hospitals affiliated with the Indiana University School of Medicine and from the Mayo Clinic in Rochester, Minnesota. Intervention: A music intervention comprising classical and contemporary tracks, delivered twice daily through noise-canceling headphones and tablets for up to 7 days, was compared to active control listening to a silence track delivered under identical conditions. Main Outcomes and Measures: The primary outcome was delirium/coma-free days during the 7-day intervention period assessed by the Confusion Assessment Method for the ICU (CAM-ICU) and the Richmond Agitation-Sedation Scale. The secondary outcomes were delirium severity assessed by the CAM-ICU-7, pain assessed by the Critical Care Pain Observation Tool, and anxiety assessed by the visual analog scale for anxiety (VAS-A). Results: A total of 158 patients were randomized (mean [SD] age, 68 (9.2) years; 72 [45.5%] female and 86 [54.4%] male). In an inte...