Intensive Care Unit Environment Clinical Trial
Official title:
eValuatIon of The ALl New Environment for crITicallY Ill Patients (VITALITY)
The purpose of this prospective observational study is to investigate if mechanically
ventilated patients who are treated in one of the new intensive care unit (ICU) rooms have
less delirium compared to patients who are treated in the conventional rooms on the same ICU.
The investigators will further evaluate the impact on sleep quality, circadian rhythm, global
cognitive function and general outcome parameters.
The investigators recorded light and noise conditions in the ICU rooms before start of the
redesigning process (subproject light and noise in the intensive care unit (LiNo-ICU)). The
investigators will compare data regarding light and noise in the ICU rooms before and after
the redesigning process (non-patient related data; ethical vote amendment 08.05.2014).
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 the most common independent
risk factor for transitioning to delirium. However, the no-sedation approach is often
challenging. ICU patients who are not sedated often develop severe anxiety and agitation.
These symptoms are often treated with sedatives that have delirogenic side effects.
One of the major reasons for anxiety and agitation of patients is the ICU environment which
causes distress. The feelings of being surveyed all the time by monitors, being exposed to
different kinds of machinery or equipment which sometimes do not work properly are major
stressors.
The objective of the interdisciplinary research project "Parametrische (T)Raumgestaltung" was
the development of two redesigned intensive care rooms that help to reduce patients' anxiety,
helplessness and stress through a holistic architectural approach. The patient's perception
and needs, his or her obvious feelings of helplessness and fear are the starting point for a
concept that is able to reduce stress factors such as functional and purely technical
environment, insufficient lighting conditions and noise. Minimizing or eliminating these
common stress factors in the ICU could reduce the need for sedatives and thereby reducing the
incidence of ICU delirium.
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