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Pairing music with awakening trials reduced sedation exposure and improved comfort and clarity in individuals receiving mechanical ventilation in the ICU. 

A study published in the June 2025 issue of Journal of Intensive Care Medicine by researchers was conducted to determine whether protocolized music intervention paired with spontaneous awakening trials (SAT) was a feasible approach to reduce sedation exposure in individuals on mechanical ventilation and sedated intensive care unit (ICU).  

They included individuals admitted to the medical ICU (MICU) or surgical ICU (SICU) who were mechanically ventilated for at least 24 hours and expected to require ventilation for a minimum of 72 hours, with hearing optimized to baseline disposition. Individuals with a specified diagnosis before admission, traumatic or medical encephalopathy, or requiring deep sedation were excluded. Eligible participants were randomized to receive either a music intervention or usual care during the SAT. Those in the music intervention group were further randomized to either Commercial Music Intervention (CMI) or Preference Music Intervention (PMI). Sedation exposure was assessed using the Sedation Intensity Score (SIS), which summed the frequency and intensity of sedative medications from various drug classes (e.g., opioids, anxiolytics, antipsychotics) for comparison.  

The results showed that the usual care group had a higher median SIS compared to the music intervention group (4 [IQR 4.9–6.4] vs 3 [IQR 3.1–4.2], P= .0006). Individuals receiving PMI had a greater mean SIS than those receiving CMI (5 ± 2.4 vs 2.3 ± 1.7, P= .0002). The music intervention group had a higher proportion of delirium-free ICU days compared to usual care (37% vs 22%, P= .009) and a greater percentage of CPOT scores at target (69% vs 52%, P= .002). No difference was observed in the proportion of sedation scores at goal (64% vs 67%, P= .7).  

Investigators concluded that protocolized music intervention combined with daily SATs was a feasible routine approach for individuals on mechanical ventilation, with further research needed to confirm its impact on reducing sedation requirements. 

Source: journals.sagepub.com/doi/10.1177/08850666251343799