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Decreasing Delirium through music (DDM) in critically ill older adults

通过音乐 (DDM) 减少危重老年人的谵妄

基本信息

批准号：
10421291
负责人：
Linda L Chlan
金额：
$ 38.58万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-15 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10421291
关键词：
Achievement Acute respiratory failure Adherence Adult Agitation Analgesics Anti-Anxiety Agents Anxiety Arousal Caring Clinical Trials Cognitive Coma Conduct Clinical Trials Critical Care Critical Illness Delirium Dementia Dose Elderly Generalized Anxiety Disorder Guidelines Health Hospitals Hydrocortisone Impaired cognition Indiana Inflammatory Intensive Care Units Intervention Investigation Knowledge Length Length of Stay Measures Mechanical Ventilators Mechanical ventilation Medicine Mental Depression Music Neuraxis Neuropsychology Noise Norepinephrine Outcome Pain Pain management Pathway interactions Patient-Focused Outcomes Patients Pharmaceutical Preparations Pharmacology Production Questionnaires Randomized Randomized Clinical Trials Randomized Controlled Trials Risk Sedation procedure Severities Signal Transduction Sleep disturbances Societies Stress Surveys Testing United States Universities Visual acceptability and feasibility adverse outcome analog anxiety symptoms arm associated symptom attentional control brain health care costs cognitive development confusion assessment method cytokine design efficacy evaluation efficacy testing experience feasibility trial group intervention high risk improved mortality mortality risk pain symptom prescription opioid primary outcome research study secondary outcome sedative telephone-based tool treatment arm

项目摘要

PROJECT ABSTRACT One million adults in the United States receive mechanical ventilation for acute respiratory failure in the intensive care units (ICUs) annually and up to 80% of them develop delirium during their ICU stay. Presence of delirium predisposes older adults to immediate in-hospital complications including a longer length of ICU and hospital stay, increased risk of in-patient mortality and elevated costs of care. In addition, ICU delirium is associated with long-term post-discharge complications such as development of cognitive impairment and dementia. Recent research studies exploring pharmacological strategies to manage ICU delirium have not demonstrated efficacy; a limitation also acknowledged in the Society of Critical Care Medicine 2018 Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption guidelines. Music listening is a non-pharmacological intervention that has shown to decrease over-sedation, anxiety and stress in critically ill patients, factors that could predispose to ICU delirium. We conducted a randomized pilot clinical trial, which showed that slow-tempo relaxing music could improve delirium/coma free days in mechanically ventilated critically ill patients. Our team is now proposing to conduct a large randomized clinical trial called “Decreasing Delirium through Music (DDM) in Critically Ill Older Adults to evaluate the efficacy of a seven-day slow-tempo music intervention on the primary outcome of delirium/coma free days among mechanically-ventilated older adults admitted to the ICU. The trial has the following aims: 1. Test the efficacy of music intervention in improving delirium/coma free days among mechanically ventilated patients as compared to attention control. 2. Test the efficacy of music intervention in improving delirium severity, pain and anxiety among mechanically ventilated patients as compared to attention control. 3. Test the efficacy of music intervention in improving the long-term neuropsychological outcomes as compared to attention control. Achievement of the aforementioned aims will provide an efficacious and scalable intervention to reduce delirium and improve brain health.

项目摘要