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

Abstract

Background: A wide range of reviews have demonstrated the effectiveness and tolerability of Virtual Reality (VR) in a range of clinical areas and subpopulations. However, no previous review has explored the current maturity, acceptability, tolerability, and effectiveness of VR with intensive care patients.

Aims: To identify the range of uses of VR for intensive care patients, classify their current phase of development, effectiveness, acceptability, and tolerability.

Methods: A scoping review was conducted. A multi-database search was undertaken (inception to January 2021). Any type of study which examined the use of VR with the target application population of intensive care patients were included. Screening, data extraction, and assessment of quality were undertaken by a single reviewer. A meta-analysis and a descriptive synthesis were undertaken.

Results: Six hundred and forty-seven records were identified, after duplicate removal and screening 21 studies were included (weak quality). The majority of studies for relaxation, delirium, and Post Traumatic Stress Disorder (PTSD) were at the early stages of assessing acceptability, tolerability, and initial clinical efficacy. Virtual Reality for relaxation and delirium were well-tolerated with completion rates of target treatment of 73.6%, (95% CI:51.1%-96%, I² = 98.52%) 52.7% (95% CI:52.7%-100%, I² = 96.8%). The majority of reasons for non-completion were due to external clinical factors. There were some potential benefits demonstrated for the use of VR for relaxation, delirium, and sleep.

Conclusion: Virtual Reality for intensive care is a new domain of research with the majority of areas of application being in the early stages of development. There is great potential for the use of VR in this clinical environment. Further robust assessment of effectiveness is required before any clinical recommendations can be made.

Relevance to clinical practice: Virtual reality for ICU patients is in its infancy and is not at a stage where it should be used as routine practice. However, there is early evidence to suggest that virtual reality interventions have good acceptability and tolerability in intensive care patients for relaxation, delirium, and improving sleep.

Keywords: acceptability; effectiveness; intensive care; tolerability; virtual reality.