Virtual reality and human consciousness: The use of immersive environments in delirium therapy

Abstract

Immersive virtual environments can produce a state of behaviour referred to as ‘presence’, during which the individual responds to the virtual environment as if it were real. Presence can be arranged to scientifically evaluate and affect our consciousness within a controlled virtual environment. This phenomenon makes the use of virtual environments amenable to existing and in-development forms of therapy for various conditions. Delirium in the intensive care unit (ICU) is one such condition for which virtual reality (VR) technology has not been evaluated to date. We are currently assessing the feasibility and utility of a delirium prevention and treatment system, which implements VR to improve quality of sleep, reduce pain, lower usage of sedatives, and stimulate cognition. The proposed system will consist of 3-axis wearable accelerometers, 6-DOF position trackers, a VR system and apps designed to promote sleep quality and mindfulness. Our a priori hypothesis is that our VR therapy system would lower the occurrence of delirium in patients admitted to ICUs.

Scoping review of the use of virtual reality in intensive care units

“…All included studies were published between 2017 to 2020 18,43‐66 with the majority published in 2020 18,48,51‐53,56‐58,61,64,65 . The country of study varied with studies taking place in France, 55,56 Netherlands, 58,59,63 Singapore, 60 South Korea, 51,52 Switzerland, 45‐47,57 United Kingdom, 53,54 and the United States 18,43,44,48‐50,61,64,65,67 .…”

“…The remaining papers were excluded due to not using VR headsets or being a commentary piece (see Figure 1 for PRISMA flow diagram 42 ). This resulted in 15 completed published studies and six registered trials being identified 18,43‐66 …”

“…18,48,67 With 90.5% 67 and 95.6% 18 of ICU patients agreeing that the VR headset was comfortable and 100% of ICU patients judged the VR headset to be at least moderately comfortable. 48 Ong et al 18 and Suvajdzic et al 62 reported that 80% and 88.9% of ICU patients respectively liked the experience of using VR. Jawed et al reported that 13.3% were slightly dizzy and 6.7% had nausea.…”

A New Virtual World? The Future of Immersive Environments in Anesthesiology

“…63 IVEs are now being investigated as part of a multimodal approach in screening for and preventing cognitive impairments as well as treating delirium in critical care settings. [65][66][67][68] Ideally, as these studies evolve, anesthesiologists will be able to use IVE software in their clinics to stratify delirium risk preoperatively, educate patients and their families about risks, and then implement a protocol (potentially with IVEs as a structural element) postoperatively to prevent or treat delirium. Imagine virtually transporting a delirious patient back into their home, where they can interact with their native environment and virtually present family?…”

Questionnaire Measures and Physiological Correlates of Presence: A Systematic Review

“…The constructs of immersion, involvement, and emotion are difficult to disentangle from presence itself (Slater, 2003). Several studies have considered the difference between these terms and related constructs (Nacke and Lindley, 2008;Cummings and Bailenson, 2016;Suvajdzc et al, 2018). Generally, immersion refers to the outcome of immersive technology when evaluated objectively (Nilsson et al, 2016).…”