Delirium Reduction via Scripted Family Voice Recordings in Critically Ill Patients Receiving Mechanical Ventilation

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BACKGROUND: Delirium affects many critically ill patients receiving mechanical ventilation and is an independent predictor of death, length of stay, cost of care, and acquired dementia. More evidence is needed for nonpharmacological interventions that reduce delirium in patients receiving mechanical ventilation in intensive care units (ICUs). OBJECTIVES: A structured intervention, Family Automated Voice Recording (FAVoR), used recorded voices of family members to provide patients receiving mechanical ventilation with hourly reorientation to the ICU environment during daytime hours. The primary aim was to compare the effect of the FAVoR intervention vs usual care on delirium in adults receiving mechanical ventilation in the ICU. METHODS: This prospective, 2-arm, blinded randomized controlled trial included 178 adults receiving mechanical ventilation in 9 ICUs at 2 large hospitals in south Florida. Delirium was measured with the Confusion Assessment Method for the ICU, administered by study personnel twice daily for 7 days or until ICU discharge. Data analyses included descriptive statistics, χ2 tests, and multivariable modeling analysis following the intent-to-treat principle. RESULTS: Clinical characteristics and demographics were similar between groups. Patients in the FAVoR group (n = 89) had more delirium-free days than did those in the usual-care group (n = 89) (P < .001). Response to the intervention was dose dependent; more doses of intervention were associated with less delirium (P < .001). CONCLUSIONS: The FAVoR intervention is a nonpharmacological, low-resource-using intervention to reorient ICU patients receiving mechanical ventilation. In this trial, FAVoR was effective in preventing delirium among these patients. ClinicalTrials.gov identifier: NCT03128671.

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