Critical care (London, England) · 2026
ICU-specific virtual reality for mental health after critical illness: an international three-arm randomized clinical trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Drop Denzel L Q, Vlake Johan H, van Bommel Jasper, Wils Evert-Jan, Hilling Denise E, Korevaar Tim I M, Taccone Fabio S, Devroey Marianne, So Ralph K L, den Uil Corstiaan A, Schut Anna F C, Raben Adrienne M T J, Elderman Jan H, Achterberg Sefanja, Festen Barbara, Dijkstra Annemieke, van Mol Margo M C, Jung Christian, Gommers Diederik, van Genderen Michel E
Аннотация
BACKGROUND: Survivors of critical illness frequently experience symptoms of post-intensive care syndrome (PICS), including post-traumatic stress disorder (PTSD), anxiety, and depression, with downstream impact on health-related quality of life (HRQoL). We evaluated whether an intensive care unit-specific virtual reality (ICU-VR) video improves mental health outcomes and whether timing (early vs. late) matters.
METHODS: We conducted an international, three-arm, multicentre randomized clinical trial across eleven hospitals. Adults (≥ 18 years) with ICU stay ≥ 72 h and mechanical ventilation ≥ 24 h were randomized 1:1:1 to (1) standard care, (2) early ICU-VR (within 7-15 days post-ICU), or (3) late ICU-VR (≈ 3 months, during aftercare). The primary endpoint was PTSD symptom severity at six months (T3) measured by the Impact of Event Scale-Revised (range 0-88). Secondary endpoints included anxiety/depression severity and prevalence, and HRQoL.
RESULTS: We randomized 344 participants (median age 61 years; 62% male); follow-up among survivors at six months (T3) was 80%. At six months, PTSD symptom severity did not differ between early ICU-VR and control (β = 0.32; 95% CI -3.38 to 4.02; p = 0.87) nor late ICU-VR and control (-0.82; 95% CI -4.62 to 2.97; p = 0.67). No between-group differences were observed for anxiety, depression, or HRQoL (all adjusted p > 0.05). Patients rated ICU-VR highly for improving understanding of the ICU experience and overall satisfaction (median 8/10).
CONCLUSIONS: In this multicentre randomized clinical trial, a single ICU-VR video did not improve PTSD, anxiety, depression, or HRQoL at six months versus standard care. Findings should not be generalized to multi-session, therapist-guided, or personalized VR interventions. Future trials should target high-risk patients, make multi-session mandatory, and personalize ICU-VR.
TRIAL REGISTRATION: This study was prospectively registered Netherlands: Trial Register/International Clinical Trials Registry Platform, NL9812, October 21, 2021.
METHODS: We conducted an international, three-arm, multicentre randomized clinical trial across eleven hospitals. Adults (≥ 18 years) with ICU stay ≥ 72 h and mechanical ventilation ≥ 24 h were randomized 1:1:1 to (1) standard care, (2) early ICU-VR (within 7-15 days post-ICU), or (3) late ICU-VR (≈ 3 months, during aftercare). The primary endpoint was PTSD symptom severity at six months (T3) measured by the Impact of Event Scale-Revised (range 0-88). Secondary endpoints included anxiety/depression severity and prevalence, and HRQoL.
RESULTS: We randomized 344 participants (median age 61 years; 62% male); follow-up among survivors at six months (T3) was 80%. At six months, PTSD symptom severity did not differ between early ICU-VR and control (β = 0.32; 95% CI -3.38 to 4.02; p = 0.87) nor late ICU-VR and control (-0.82; 95% CI -4.62 to 2.97; p = 0.67). No between-group differences were observed for anxiety, depression, or HRQoL (all adjusted p > 0.05). Patients rated ICU-VR highly for improving understanding of the ICU experience and overall satisfaction (median 8/10).
CONCLUSIONS: In this multicentre randomized clinical trial, a single ICU-VR video did not improve PTSD, anxiety, depression, or HRQoL at six months versus standard care. Findings should not be generalized to multi-session, therapist-guided, or personalized VR interventions. Future trials should target high-risk patients, make multi-session mandatory, and personalize ICU-VR.
TRIAL REGISTRATION: This study was prospectively registered Netherlands: Trial Register/International Clinical Trials Registry Platform, NL9812, October 21, 2021.