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Semin Respir Crit Care Med 2019; 40(05): 673-686
DOI: 10.1055/s-0039-1698404
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

Alawi Luetz
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
2   Department of Healthcare Management, Technische Universität Berlin, Berlin, Germany
,
Julius J. Grunow
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
,
Rudolf Mörgeli
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
,
Max Rosenthal
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
,
Steffen Weber-Carstens
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
,
Bjoern Weiss
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
,
Claudia Spies
1   Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
11 December 2019 (online)

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Abstract

Delirium, the most common form of acute brain dysfunction affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long-term cognitive impairment, one of the domains in “Post-ICU Syndrome” (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep–wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.

Keywords

critical care - intensive care unit - architecture - post–intensive care unit syndrom - delirium - nonpharmacological - light - noise - sound - mobility - physiotherapy
 

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