Family-Recorded Messages: A New Frontier in ICU Delirium Management

Family-recorded messages increased delirium-free days in mechanically ventilated ICU patients versus standard care in a randomized trial—showing a measurable, clinically relevant benefit.

The trial enrolled 178 mechanically ventilated patients and found a statistically significant rise in delirium-free days with family-recorded audio compared with usual care.

This low-cost, scalable nonpharmacologic option is an immediately deployable adjunct to usual care and warrants consideration by critical care teams seeking pragmatic delirium-prevention strategies.

Previous sedation-focused approaches gave way to nonpharmacologic strategies designed to reorient and calm patients, but implementation has been limited by inconsistent family presence and workflow barriers. This randomized controlled trial used delirium-free days as the primary endpoint and produced a favorable, statistically significant result for the audio intervention, strengthening the case for adding personalized recordings to established delirium-prevention bundles.

The reported protocol is operationally simple: obtain family consent, use a basic audio player or hospital tablet on a defined playback schedule, apply infection-control cleaning, and document bedside playback. Teams should review the original trial methods and local infection-control policies before adopting a specific protocol.

Familiar voice and reorientation likely explain the effect by reducing stress and improving cognitive anchoring. The greatest benefit appears in patients who are alert enough to process auditory cues while ventilated, so it's important to account for hearing impairment, language mismatch, and device-cleaning constraints.