Clinical Application of Listening to Music to Prevent Delirium in the Intensive Care Unit

Who can take part

• Age 65 years or older
• Negative Confusion Assessment Method for the ICU (CAM-ICU) at the time of randomization
• Expected ICU length of stay of at least 48 hours based on clinical judgement at admission (e.g., need for mechanical ventilation, vasopressors, invasive monitoring)

Who cannot take part

• Positive CAM-ICU prior to randomization
• Severe chronic cognitive impairment or advanced dementia, defined by a known history of severe functional dependence prior to admission (requiring permanent assistance for basic activities of daily living such as feeding or grooming)
• Suspected or confirmed intoxication with drugs or alcohol at admission
• Acute primary Central Nervous System pathology (e.g., ischemic or hemorrhagic stroke, traumatic brain injury, meningoencephalitis, intracranial hypertension) presenting with altered sensorium (Glasgow Coma Scale at admission < 14) or focal deficit preventing cognitive assessment (e.g., severe aphasia)
• Unresolved auditory or visual impairment
• Uncontrolled psychiatric disease (at least one acute episode requiring intervention in the last 6 months)
• Medical condition precluding the safe use of headphones (e.g., burns, skull fracture, skin lesions)
• Inability to establish effective communication due to a language disorder or unresolved language barrier
• Richmond Agitation-Sedation Scale (RASS) score < -2 or > +2 at the time of randomization
• Inability of the patient or legal representative to provide informed consent
• Patients with imminent death, end-of-life care, or limitation of therapeutic effort