Study: Preoperative VR reduces ICU sedation, ventilator time

Editor's Note

A recent study shows potentially significant promise for preoperative virtual reality (VR) simulation to improve surgical patient outcomes.

Published March 1 in the American Journal of Critical Care, the research details how VR reduced ICU sedation and ventilator time for patients undergoing elective cardiothoracic surgery. Although the program did not lower the incidence of postoperative delirium, it improved patients’ overall ICU experience and decreased anxiety.

Led by researchers at Mayo Clinic, the study involved developing a VR simulation that immerses patients in a realistic ICU environment from the perspective of a postoperative cardiothoracic surgery patient. The video, captured using a 360° camera with spatial audio, featured real healthcare staff interacting with the patient and explaining their roles. The goal was to familiarize patients with the environment and alleviate common fears associated with ICU recovery.

The study included 138 patients: 94 in a historical control group and 44 in the VR simulation group. All participants underwent elective cardiothoracic surgery with a planned ICU recovery involving mechanical ventilation. The VR group watched the 10-minute simulation before surgery, while the control group received standard care.

The VR simulation group experienced 5.66 hours shorter ICU sedation duration and 5.69 hours shorter ventilator time  compared to the control group (P = .02). The simulation group also had lower incidence of antipsychotic medication use (1 dose vs. 16) and reduced ICU length of stay (1.44 days vs. 1.98 days). Delirium rates did not differ significantly (4 cases in the control group and 1 case in the VR group).

Further, qualitative feedback revealed that patients who experienced the VR simulation reported less preoperative anxiety and a greater sense of preparedness for their ICU stay, researchers write. Most VR group participants (92%) stated that the simulation positively influenced their experience.

Limitations of the study include differences between the historical and current patient groups and potential bias related to changes in ICU practices over time. Nonetheless, researchers concluded that preoperative VR simulation shows promise as an educational tool to enhance ICU readiness, reduce anxiety, and improve postoperative outcomes, recommending further research.