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Modrykamien AM. Enhancing the awakening to family engagement bundle with music therapy. World J Crit Care Med 2023; 12(2): 41-52 [PMID: 37034022 DOI: 10.5492/wjccm.v12.i2.41]
World J Crit Care Med. Mar 9, 2023; 12(2): 41-52 Published online Mar 9, 2023. doi: 10.5492/wjccm.v12.i2.41
Enhancing the awakening to family engagement bundle with music therapy
Ariel M Modrykamien
Ariel M Modrykamien, Department of Pulmonary and Critical Care, Baylor University Medical Center, Dallas, TE 75246, United States
Author contributions: Modrykamien AM Planned and wrote manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Ariel M. Modrykamien, MD, Chief of Critical Care Medicine, Department of Pulmonary and Critical Care, Baylor University Medical Center, 3600 Gaston Ave., Dallas, TX 75246, United States. ariel.modrykamien@bswhealth.org
Received: October 27, 2022 Peer-review started: October 27, 2022 First decision: December 19, 2022 Revised: December 19, 2022 Accepted: February 2, 2023 Article in press: February 2, 2023 Published online: March 9, 2023 Processing time: 130 Days and 9.5 Hours
Abstract
Survivors of prolonged intensive care unit (ICU) admissions may present undesirable long-term outcomes. In particular, physical impairment and cognitive dysfunction have both been described in patients surviving episodes requiring mechanical ventilation and sedation. One of the strategies to prevent the aforementioned outcomes involves the implementation of a bundle composed by: (1) Spontaneous awakening trial; (2) Spontaneous breathing trial; (3) Choosing proper sedation strategies; (4) Delirium detection and management; (5) Early ICU mobility; and (6) Family engagement (ABCDEF bundle). The components of this bundle contribute in shortening length of stay on mechanical ventilation and reducing incidence of delirium. Since the first description of the ABCDEF bundle, other relevant therapeutic factors have been proposed, such as introducing music therapy. This mini-review describes the current evidence supporting the use of the ABCDEF bundle, as well as current knowledge on the implementation of music therapy.
Core Tip: Data support the implementation of the (1) Spontaneous awakening trial; (2) Spontaneous breathing trial; (3) Choosing proper sedation strategies; (4) Delirium detection and management; (5) Early ICU mobility; and (6) Family engagement bundle for mechanically ventilated patients. The role of music therapy is evolving.
