the most disruptive technology for treating patients in the ICU turns out to be an MP3 file

When we think about the advances in hospitals to improve survival or recovery of patientswe can come to think of better respirators, monitors that offer thousands of data or new drugs that are almost miraculous. However, science has given us a blow of reality by demonstrating that accompanying families during hospital stays offers great results.

This is something that has been seen directly in a hospital’s ICU itself, where patients are between life and death. That is why a study decided to use something as ‘low-tech’ as It is a voice recording of a family member to see the real impact it could have on his recovery. And the truth is that we have been underestimating the usefulness of this clinical tool.

The problem. One of the big problems faced by patients entering the ICU is the ‘delirium’. A state of great confusion resulting from an acute failure of the nervous system that affects up to 80% of patients that have mechanical ventilation. And this is something terrible within these units.

Not because it is annoying for the patient to be in a great state of confusion, but because it has been seen that mortality, hospital stay and all this increase. leads to higher costs for the healthcare system. Something that has been calculated and that points to an expense of between 6,000 and 20,000 million dollars annually. And the worst thing: current drugs (sedatives, antipsychotics) are often part of the problem or are not entirely effective in preventing it.

The solution. Once we had the problem, Cindy Munro proposed a simple but powerful hypothesis to solve it: if the brain “disconnects” from reality due to isolation and sedation, can we use a familiar voice to bring it back?

The test. In order to see if this was possible or not, a study was carried out that included 178 patients from two large hospitals in Florida and which had the collaboration of five large universities. The goal was clear: treat sound almost as if it were medicine.

To do this, a protocol was created to play the audio so that it was not simply connecting the radio or mobile phone and allowing the patient to listen. The standard was to use common audio players, with two-minute clips recording the families and a playback that would be done twice a day: at 9 in the morning and at 4 in the afternoon.

The time was not chosen at random, but was designed to ‘hack’ the circadian rhythm. Listening to familiar voices during the day helps the brain orient itself temporally, reinforcing the difference between day and night, something that is completely lost under the artificial lights of an ICU.

The result. In addition to offering a positive result to the patients’ condition, it was also seen to have a dose-dependent effect like medications. That is, the more messages patients received, the greater the reduction in delirium in the ICU.

Why this matters. Today the industry does not cease its attempts to search for complex molecules to protect the brain, regenerate cells and countless other techniques. But the reality is that the solution seems to lie in our evolutionary biology (or at least a little help): reacting to the voices of our ‘tribe’.

Images | Stephen Andrews

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