Evaluation of a New ICU Environment
VITALITY, A prospective observational cohort study
Delirium is one of the most frequently seen brain organ dysfunctions in the intensive care unit (ICU). Depending on the ICU population, up to 87% have delirium at some point during their critical illness. Patients with delirium have a 3fold increased risk of dying compared to patients without delirium.
Studies could show that sedation is one of the most common independent risk factor for transitioning to delirium. However, a no-sedation approach is often challenging: ICU patients often suffer from symptoms of severe anxiety and agitation. One of the major reasons for the development of anxiety and agitation in critically ill patients is the ICU environment itself. The feelings of being surveyed all the time by monitors, being exposed to different kinds of machinery or equipment are reported to be major stressors.
Together with our project partners ART+COM and GRAFT Architects we developed a new intensive care room concept to reduce patients' anxiety, helplessness, and stress. The patient's perceptions and needs were the starting point of this project.
Besides the interventions aimed at noise shielding and the change of workflow, we conducted modifications to improve lighting conditions: One integral part of the room is a new light-ceiling for each bed that extends from the head above the patient down to the patients’ feet and covers an area of 15 square meters.
The purpose of the prospective observational study is to investigate if mechanically ventilated patients treated in one of the new ICU rooms, have less delirium compared to patients treated in the standard rooms. We further evaluate the impact on sleep quality, circadian rhythmicity, global cognitive function and general outcome parameters. For more information visit ClinicalTrials.gov.