Virtual Reality for Anxiety Management in Mechanically Vented Patients

Mechanically ventilated patients (those on a breathing machine) often experience heightened
levels of anxiety and discomfort. This is usually treated by using sedative medications,
however these drugs often have unintended side effects. This study will investigate the
safety and feasibility of using relaxing virtual reality environments for reduction of
anxiety in mechanically ventilated patients.

Inclusion Criteria:

Age: 18 years or older

1. Mechanically ventilated; defined as having an endotracheal tube or tracheostomy and
requiring continuous support from a mechanical ventilator.

2. Able to spontaneously maintain a state of wakefulness and alertness and able to follow
commands

3. Able to communicate with research staff; defined as writing or head nods/shakes

Exclusion Criteria:

1. Delirious; defined as positive on the Confusion Assessment Method for the ICU (CAM-ICU
+)

2. Expected to be liberated from ventilator within 12 hours of potential enrollment

3. Existence of skull injury or recent surgery (craniectomy) which precludes safely
wearing VR visor

4. Impaired ability to see or hear, as determined by study investigator

5. Ventilator settings with positive end expiratory pressure (PEEP) greater than 10

6. Inability to be safely removed from physical restraints for VR (virtual reality)
sessions

7. Chronic ventilator dependence prior to the present hospitalization

8. Lacking capacity to consent for one's self

9. Known difficult airway; based on review of intubation note

10. Tracheostomy performed within last seven days

11. Pre-existing symptoms overlapping with major symptoms of cyber-sickness: Headache,
Vertigo (dizziness), Ataxia (tremor with movement), Nausea, Vomiting.