To assess the impact of different electronic relaxation devices on common stressful patient symptoms experienced in intensive care unit (ICU). Sixty critically ill patients were enrolled in four relaxation sessions using a randomized cross-over design: standard relaxation (TV/radio), music therapy (MUSIC-CARE©), and two virtual reality systems using either real motion pictures (DEEPSEN©) or synthetic motion pictures (HEALTHY-MIND©). The goal was to determine which device was the best to reduce overall patient discomfort intensity (0–10 Numeric Rating Scale (NRS); primary endpoint). Secondary endpoints were specific stressful symptoms (pain, anxiety, dyspnea, thirst, and lack of rest feeling) and stress response measured by Analgesia/Nociception Index (ANI). Multivariate mixed-effect analysis was used, taking into account patient characteristics and multiple measurements. Fifty patients followed the full research protocol, and ten patients did at least one research planned session of relaxation. HEALTHY-MIND© was associated with a significant decrease in overall discomfort, the primary endpoint (median NRS = 4[2–6] vs. 2[0–5]; p = 0.01, mixed-effect model), accompanied by a significant decrease in stress response (increase in ANI, secondary endpoint; p < 0.01). Regarding other secondary endpoints, each of the two virtual reality systems was associated with a decrease in anxiety (p < 0.01), while HEALTHY-MIND© was associated also with a decrease in pain (p = 0.001) and DEEPSEN© with a decrease in lack of rest (p = 0.01). Three incidents (claustrophobia/dyspnea/agitation) were reported among 109 virtual reality sessions. Cybersickness was rare (NRS = 0[0–0]). Electronic relaxation therapy is a promising, safe, and effective non-pharmacological solution that can be used to improve overall discomfort in alert and non-delirious ICU patients. Its effectiveness depends on technical characteristics (virtual reality using a synthetic imagined world versus a real world or music therapy alone without virtual reality), as well as the type of symptoms.

中文翻译：

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使用电子放松设备改善重症患者的不适：交叉随机对照试验 E-CHOISIR（重症监护放松系统的电子选择）的结果

评估不同电子放松设备对重症监护病房 (ICU) 中常见的压力患者症状的影响。60 名危重患者参加了使用随机交叉设计的四个放松课程：标准放松（电视/广播）、音乐疗法（MUSIC-CARE©）和两个使用真实电影（DEEPSEN©）或合成电影 (HEALTHY-MIND©)。目标是确定哪种设备最能降低患者的整体不适强度（0-10 数字评定量表 (NRS)；主要终点）。次要终点是特定的压力症状（疼痛、焦虑、呼吸困难、口渴和缺乏休息感）和通过镇痛/伤害感受指数 (ANI) 测量的压力反应。采用多变量混合效应分析，考虑到患者特征和多次测量。50 名患者遵循完整的研究方案，10 名患者至少进行了一项研究计划的放松。HEALTHY-MIND© 与主要终点（中位 NRS = 4[2-6] vs. 2[0-5]；p = 0.01，混合效应模型）的总体不适感显着降低相关，伴随着显着应激反应降低（ANI 增加，次要终点；p < 0.01）。关于其他次要终点，两个虚拟现实系统中的每一个都与焦虑的减少有关（p < 0.01），而 HEALTHY-MIND© 也与疼痛的减少有关（p = 0.001），而 DEEPSEN© 与疼痛的减少有关。缺乏休息（p = 0.01）。在 109 个虚拟现实会话中报告了 3 起事件（幽闭恐惧症/呼吸困难/激动）。晕机病很少见（NRS = 0[0-0]）。电子放松疗法是一种有前途、安全且有效的非药物解决方案，可用于改善警觉和非谵妄的 ICU 患者的整体不适。它的有效性取决于技术特征（使用合成想象世界的虚拟现实与真实世界或没有虚拟现实的单独音乐疗法）以及症状的类型。