VR Interventions to Reduce the Prevalence of Delirium in ICU Patients

Peking Union Medical College Hospital102 enrolled

Overview

The goal of this clinical trial is to learn the effect of Virtual Reality Family Support System (VRFS) on reducing delirium in ICU mechanically ventilated patients. The main question it aims to answer is: ·Using VRFS for participant intervention, can it reduce the incidence of delirium and improve clinical outcomes? Researchers will investigate whether the implementation of VRFS can reduce the number of delirium days and improve clinical outcomes. Participants will: * Receive the VRFS intervention until the endotracheal tube (ETT) is removed. * Have physiological data collected, including EEG, oxygen saturation levels, ECG, and blood pressure. * Keep a diary of delirium, dosage of sedative and analgesic drugs, the duration of mechanical ventilation, and ICU stays.

During the VRFS interventions, researchers will fit participants with a VR headset and noise-canceling headphones, shielding them from the ICU environment while allowing family members to be present and offer companionship and comfort.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

102

Conditions

Delirium

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria * Mechanical ventilation duration is expected to be greater than 24 hours; * ICU stay duration is expected to be greater than 72 hours; * Age is 18 years or older, with no upper age limit; * Language: Chinese. Exclusion Criteria * Severe visual or auditory impairments (diplopia, low vision due to macular degeneration, retinopathy; severe hearing loss or deafness); * Cognitive and consciousness disturbances prior to ICU admission; * Severe motion sickness; * Head trauma or surgery that prevents the wearing of equipment; * A history of long-term use of antipsychotic and/or benzodiazepine medications.

Outcomes

Primary Outcomes

Delirium Day

Delirium is monitored and evaluated by the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). The CAM-ICU has four items ((1) altered mental status/fluctuating course, (2)inattention, (3) altered level of consciousness, and (4) disorganized thinking) and each item has two factors (positive or negative). The physicians can diagnose the patients with delirium when the results of item (1), item (2), and item (3) or item (4) are positive.

Time frame: Twice daily from Day 1 through ICU discharge, an average of 7 days.

Secondary Outcomes

ICU Days

The ICU stays are daily recorded by the physicians and nurses in ICU.

Time frame: From ICU admission through ICU discharge, an average of 7 days.

Duration of Mechanical Ventilation

The duration of mechanical ventilation is daily recorded by the physicians and nurses.

Time frame: From the start of mechanical ventilation through endotracheal tube (ETT) removal, an average of 6 days.

Dosage of sedative and analgesic drugs

Daily records by doctors and nurses.

Time frame: Daily from Day 1 through ICU discharge, an average of 7 days.

Incidence of Delirium

The proportion of participants who experience at least one CAM-ICU-positive episode during their ICU stay, assessed twice daily using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

Time frame: Twice daily from Day 1 through ICU discharge, an average of 7 days.

Family Satisfaction with Care in the Intensive Care Unit (FS-ICU)

Family satisfaction is assessed using the FS-ICU scale, evaluating satisfaction with nursing care (FS-Care) and the decision-making process (FS-DM). The results include the total score (FS-Total) and two subscale scores (FS-Care and FS-DM).

Time frame: At baseline (Day 0) and within 3 days after ICU discharge.