pain, less anxiety and shorter hospital stay. As disorientation affects the majority of ICU patients, we decided to use the sky as a basic layer which changes color based on the time of the day. In terms of symptom complexity and diversity we decided to use parameterized visualizations: Instead of playing back pre-recorded animations, the visual content will be driven by predefined parameters. These predefined parameters include the results of routine pain, anxiety, sedation and delirium monitoring with validated scores. Conclusions: Interventions involving visual content appear to provide benefit for patients experiencing pain, anxiety and disorientation. RCTs are needed to assess the efficacy and tolerability of these interventions in critically ill patients.introduction: Prior ICU studies reporting BZ exposure to be a risk factor for delirium have failed to include important confounders, to differentiate BZ intermittent administration (IA) (either oral or IV) from BZ continuous IV infusion (CIVI), and to evaluate delirium ≥ 1/day. methods: This ongoing, prospective, cohort study evaluated consecutive adults, admitted to a 32-bed mixed ICU ≥ 24 hr over a 2 yr period without a baseline neurological condition, at least twice daily for coma (RASS ≤ -4) and delirium (CAM-ICU +). All delirium assessments were completed using a validated protocol (ISICEM 2011: P335) that included CAM-ICU assessments by both research physicians and the bedside nurse and a review of the patient record. A multinomial logistic regression model was used to quantify the odds of a daily transition to delirium and accounted for 5 different outcomes (ie. coma, delirium, neither of these, death and ICU discharge), both time-fixed confounders (n=7) and time-varying confounders (n=10), daily BZ use [adjusted to midazolam equivalents (MDZE)], BZ administration method (i.e. none, IA only or CIVI) and the 3 daily mental states (i.e. coma, delirium or neither of these). results: Among 866 patients evaluated [age (60 ± 16 yrs), mechanically ventilated (94%), medical (50%), APACHE IV score (76 ± 29)], 50% had delirium on 24% of their total (n=8338) ICU days. BZs were administered to 78% of patients on 49% of these patient's ICU days. For awake, nondelirious patients, the administration of a BZ(s) was not associated with delirium the following day. Among comatose patients, the relative risk ratio for being delirious the following day, versus being neither comatose nor delirious the following day, was 1.15 (1.00 -1.31) for IA and 0.93 (0.87-1.00) for CIVI for every one-unit increase in MDZE administered. Conclusions: BZ use appears not to be a risk factor for transitioning to delirium in patients who are awake and non-delirious. Among comatose patients, the effect of BZ use on a transition to delirium are less clear, and may depend on whether BZ are administered intermittently or by CIVI.