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

Exclusion Criteria11

• Positive CAM-ICU prior to randomization.
• 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).
• 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)
• Unresolved auditory or visual impairment.
• Suspected or confirmed intoxication with drugs or alcohol at admission.
• Uncontrolled psychiatric disease (at least one acute episode requiring intervention in the last 6 months).
• Richmond Agitation-Sedation Scale (RASS) score < -2 or > +2 at the time of randomization.
• 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.
• Inability of the patient or legal representative to provide informed consent.
• Patients with imminent death, end-of-life care, or limitation of therapeutic effort.