Visuo-acoustic stimulation that helps you to relax: A virtual reality setup for patients in the intensive care unit

Stephan M Gerber,Marie-Madlen Jeitziner,Prabitha Urwyler,Stephan M Jakob,Tobias Nef,René M Müri,Patric Wyss,Alvin Chesham

doi:10.1038/s41598-017-13153-1

Stephan M Gerber, Marie-Madlen Jeitziner + Show 6 more

Open Access

https://doi.org/10.1038/s41598-017-13153-1

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Abstract

After prolonged stay in an intensive care unit (ICU) patients often complain about cognitive impairments that affect health-related quality of life after discharge. The aim of this proof-of-concept study was to test the feasibility and effects of controlled visual and acoustic stimulation in a virtual reality (VR) setup in the ICU. The VR setup consisted of a head-mounted display in combination with an eye tracker and sensors to assess vital signs. The stimulation consisted of videos featuring natural scenes and was tested in 37 healthy participants in the ICU. The VR stimulation led to a reduction of heart rate (p = 0. 049) and blood pressure (p = 0.044). Fixation/saccade ratio (p < 0.001) was increased when a visual target was presented superimposed on the videos (reduced search activity), reflecting enhanced visual processing. Overall, the VR stimulation had a relaxing effect as shown in vital markers of physical stress and participants explored less when attending the target. Our study indicates that VR stimulation in ICU settings is feasible and beneficial for critically ill patients.

Highlights

After prolonged stay in intensive care units (ICU), patients often complain about cognitive impairment which can lead to a reduction of health-related quality of life as compared to before ICU admission[1,2]
Data analysis using linear mixed effect models (LMEMs) to generalize the findings revealed a significant reduction of vital signs (HF, t (276) = −2.704, p = 0.007, respiratory frequency (RF) t (276) = −2.020, p = 0.044 and mean arterial pressure (MAP), t (276) = −1.981, p = 0.049) during the course of the stimulation across all participants, except in SpO2 (t (277) = −1.377, p = 0.170) which did not significantly decrease during the stimulation
Even though induction of positive and reduction of stress-related and negative emotions plays an important role in the stress recovery effect of natural environments, this study focused on the effects of natural virtual environments on measures of physiological stress and visual exploration behaviour

Summary

Introduction

After prolonged stay in intensive care units (ICU), patients often complain about cognitive impairment which can lead to a reduction of health-related quality of life as compared to before ICU admission[1,2]. Sensory deprivation is caused by reduced amounts or variability of stimulation with decreased or monotonous, unpatterned and meaningless sensory input[17] It is the resulting combination of both stimulus overload and simultaneous stimulus deprivation that is believed to lead to a loss of differentiated perception, orientation and cognitive and attentional fatigue in critically ill patients[18,19,20]. Virtual-reality based cognitive stimulation can be used for improving cognitive functioning in critically ill patients while at the same time preventing stimulus overload by isolating the patient from disturbing external visual and acoustic input To avoid both sensory overload and sensory deprivation, we selected natural restorative environments with a neutral content

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