119: EVALUATION OF MUSIC INTERVENTION TO REDUCE SEDATION EXPOSURE DURING MECHANICAL VENTILATION

Introduction: Pain, agitation, and delirium (PAD) are important issues faced by critically ill patients. Pharmacologic PAD management is associated with risks including oversedation and prolonged mechanical ventilation. Music as a non-pharmacologic treatment for pain is suggested by the 2018 Society of Critical Care Medicine PAD guidelines. This ongoing pilot study is evaluating sedation exposure in mechanically ventilated patients who receive music intervention versus usual care only. Methods: The preliminary results of this prospective, randomized, single-center study included adult patients admitted to the medical or surgical ICU at an academic level 1 trauma center. Eligible patients were randomized to music intervention (MI) or usual care (UC) for three days. The primary outcome was sedation exposure via sedation intensity score (SIS), an aggregate of sedation frequency and sedation intensity, which was summed to demonstrate exposure for comparison. SIS calculation included sedatives from disparate drug classes such as opioids, anxiolytics, antipsychotics, and others. Secondary outcomes such as attainment of pain and agitation goals will be analyzed at enrollment completion. As of 8/3/22, 13 patients have been enrolled. Results: Preliminary results are available for 10 patients: 5 (50%) in the UC group and 5 (50%) in the MI group. 6 (60%) patients were admitted to surgical ICU, 2 (40%) in the UC group and 4 (80%) in the MI group. APACHE II Scores on study day 1 were similar (UC, 21 [IQR 11-25] vs. MI, 19 [IQR 18-28]; p=0.44). Patients in the UC and MI groups had similar median sedation exposure during the intervention period (4.0 [3.0-8.0] vs. 4.5 [1.8-6.0], p=0.061) and on study day 3 (3.0 [0.7-10.5] vs. 3.0 [1.0-5.0], p=0.522) while sedation exposure was significantly lower in the MI group on study day 2 (5.0 [3.0-8.3] vs. 4.0 [1.0-6.0], p=0.042). UC and MI groups had similar in-hospital mortality (2 [40%] vs. 3 [60%], p>0.99) and hospital length of stay (24.5 ± 7.0 days vs. 14.7 ± 6.5, p=0.09). Conclusions: Music intervention may be feasibly implemented for mechanically ventilated patients. The preliminary results of this pilot study demonstrate a trend toward significantly less sedation exposure in patients who received music intervention compared to usual care.