Acute Crit Care.  2022 May;37(2):230-236. 10.4266/acc.2021.00843.

Cinematic virtual reality for anxiety management in mechanically ventilated patients: a feasibility and pilot study

• Haley AC
• Wacker DA

• KMID: 2531681
• DOI: http://doi.org/10.4266/acc.2021.00843

Abstract

Background
Mechanically ventilated patients experience anxiety for many reasons. Pharmacological treatments such as benzodiazepines are commonly employed to manage anxiety; however, these therapies often cause undesired side effects. Additional therapies for anxiety management are needed. We sought to determine whether cell phone-based virtual reality therapy could feasibly be used for anxiety management in mechanically ventilated patients.
Methods
Mechanically ventilated subjects underwent at least one session of virtual reality therapy in which they were shown a cinematic video of an outdoor green space or blue space with 360° visual range of motion. Goal session duration was 5 minutes. The primary outcome was incidence of predefined patient safety events, including self-extubation and accidental removal of tubes or lines.
Results
Ten subjects underwent a total of 18 virtual reality sessions. Fifteen sessions lasted the planned 5 minutes, one session was extended at participant request, and two sessions were terminated early at participant request. There were no occurrences of the predefined safety events, and no occurrences of cybersickness. Use of a visual analog scale to measure anxiety level was feasible for this pilot study, demonstrating feasibility of this scale for future, larger scale studies.
Conclusions
Virtual reality therapy shows potential as a means of managing anxiety in patients undergoing mechanical ventilation, and further rigorous exploration with this protocol is feasible.

Keyword

Anti-anxiety agents; Anxiety; Artificial respiration; Respiratory insufficiency; Virtual reality

Figure

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  Figure 1. Flow diagram outlining screening and enrollment of participants, as well as inclusion and exclusion criteria. CAM-ICU: confusion assessment method for the intensive care unit; VR: virtual reality; PEEP: positive end-expiratory pressure.

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