Delirium Challenge in Intensive Care Medicine
Delirium, a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment, occurs in 30 percent to 80 percent of all ICU patients, making it the most common form of cognitive dysfunction in intensive care medicine1. The occurrence of this cerebral impairment during intensive care treatment has far-reaching consequences, doubling the mortality risk of patients in ICUs and even tripling mortality in the first six months following discharge from the hospital1,2. In view of these statistics, guidelines recommend systematic delirium screening for all patients in ICUs and the implementation of non-pharmacological interventions to prevent delirium, such as mobilizing patients during the day and introducing measures to promote sleep at night3.
“With VitalMinds, we have developed a new concept that combines light and sound management, circadian-effective light therapy, staff training and consulting services, to help hospitals reduce delirium and improve patient recovery in the ICU,” said Felix Baader, Business Leader, Monitoring Analytics at Philips. “This integrated approach is based on international ICU guidelines and supports hospitals in achieving the quadruple aim to improve patient and staff experience, deliver better health outcomes, and drive lower costs in intensive care medicine.”
VitalSky for Personalized Light Therapy
The VitalSky light therapy system provides a circadian-effective program to support the sleep-wake rhythm of patients. This program simulates the natural progression of daylight using a spectrum of glare-free white light provided by a large luminous LED ceiling. The light conditions can be personalized to the needs of the individual patient. The system also provides premium-quality workplace lighting to support favorable treatment conditions. Advanced features include the additional option of playing calming nature scenes in full-color, soft-focus video, and the future enablement of cognitive training is also planned. The various programs and settings can be selected and adjusted quickly and easily via a portable user interface.
“In the framework of a multi-component approach at Marien Hospital in Wesel, Germany, we aim to prevent delirium in the ICU. For this purpose, the light therapy technology of the VitalSky system is an essential environmental element which will help us to support the circadian rhythm of patients,” said Dr. Marc Achilles, Chief Physician of anesthesiology and intensive care medicine, Marien Hospital. “We are proud to be the first hospital worldwide where this system is installed.”
Improved Patient Environment Supports the Reduction of Delirium
Recent results from the VITALITY study of the Charité University Hospital in Berlin demonstrate the important role of an improved patient environment, including circadian-effective light therapy for the recovery process and the prevention of delirium in the ICU. The preliminary results of the VITALITY study show a statistically significant reduction of 39 percent in the incidence of delirium for patients treated in modified ICU rooms compared to patients treated in standard rooms4.
1 Ouimet S. et al., Intensive Care Med, 2007, 33(1): 66-73
2 Ely E.W. et al., JAMA, 2004, 291(14): 1753-62
3 S3 guideline for the management of delirium, analgesia and sedation in intensive care medicine (DAS guideline 2015), http://www.awmf.org/leitlinien/detail/ll/001-012.html
4 Luetz A. et al., Intensive Care Medicine Experimental, 2018, 6 (Suppl 2):40