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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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.

Keywords: Bundle; Delirium; Mechanical ventilation; Mobility; 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.