Gerber Stephan M, Jeitziner Marie-Madlen, Knobel Samuel E J, Mosimann Urs P, Müri René M, Jakob Stephan M, Nef Tobias
Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland.
Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland.
Front Med (Lausanne). 2019 Dec 10;6:287. doi: 10.3389/fmed.2019.00287. eCollection 2019.
Newly acquired long-term cognitive impairments are common among survivors of critical illness. They have been linked to the stressful situation that patients experience in the intensive care unit (ICU). In this paper we use virtual reality (VR) technology to comfort critically ill patients and reduce stress during their ICU stay. We investigate the acceptance, comfort, recollection, and visual perception of VR stimulation and how it affects physiological parameters. A VR head-mounted display was used to present immersive nature scenes to 33 critically ill cardiac surgery patients [mean age 63 years (range 32-83)]. Data was collected with an eye tracker fitted inside the VR head-mounted display to measure eye movements (250 Hz) and sensors to record physiological parameters (240 Hz). Patients received VR stimulation (for 5 min.) prior to ICU admission, during ICU stay, and 3 months after discharge. Acceptance, recollection and comfort were assessed with validated questionnaires. The number of gazed meaningful objects per minute was significantly lower during the ICU session compared to pre- and follow-up sessions, whereas mean duration of fixation on meaningful moving objects did not differ between the sessions. While respiratory rate decreased significantly during VR stimulation, heart rate and blood pressure remained constant. Post-ICU rating of VR acceptance during ICU stay was moderate to high and discomfort low. Recollection of VR was high [28/33 patients (84.8%)], while recollection of ICU stay was low [10/33 patients (30.3%)]. Eye movements indicate that patients were able to perceive and process cognitive stimulation during their ICU stay. VR was recalled better than the rest of the ICU stay and well accepted. Decreased respiratory rate during stimulation indicate a relaxing effect of VR.
新出现的长期认知障碍在危重症幸存者中很常见。它们与患者在重症监护病房（ICU）所经历的应激情况有关。在本文中，我们使用虚拟现实（VR）技术来安慰危重症患者，并在他们入住ICU期间减轻压力。我们研究了VR刺激的接受度、舒适度、回忆能力和视觉感知，以及它如何影响生理参数。使用VR头戴式显示器向33名危重症心脏手术患者[平均年龄63岁（范围32 - 83岁）]呈现沉浸式自然场景。通过安装在VR头戴式显示器内的眼动仪收集数据以测量眼动（250Hz），并使用传感器记录生理参数（240Hz）。患者在入住ICU前、入住ICU期间和出院后3个月接受VR刺激（持续5分钟）。通过经过验证的问卷评估接受度、回忆能力和舒适度。与术前和术后随访相比，ICU期间每分钟注视有意义物体的数量显著降低，而在各阶段之间，对有意义移动物体的平均注视持续时间没有差异。虽然在VR刺激期间呼吸频率显著下降，但心率和血压保持不变。在ICU住院期间，对VR接受度的ICU后评分中等至高，不适感较低。对VR的回忆率较高[28/33名患者（84.8%）]，而对ICU住院期间的回忆率较低[10/33名患者（30.3%）]。眼动表明患者在入住ICU期间能够感知和处理认知刺激。对VR的回忆比对ICU住院期间的其他部分更好，并且接受度良好。刺激期间呼吸频率降低表明VR具有放松作用。
