Objective

To determine whether potential exposure to natural light via windows is associated with reduced delirium burden in critically ill patients admitted to the ICU in a single room.

Design

Prospective single-center study.

Setting

Medical ICU of a university hospital, Paris, France.

Patients

Adult patients receiving invasive mechanical ventilation.

Methods

Consecutive patients admitted to a single room with (LIGHT group) or without (DARK group) exposure to natural light via windows were evaluated for delirium. The primary endpoint was the incidence of delirium. Main secondary endpoints included incidence of severe agitation intervened with antipsychotics and incidence of hallucinations.

Results

A total of 195 patients were included (LIGHT group: n = 110; DARK group: n = 85). The incidence of delirium was similar in the LIGHT group and the DARK group (64% vs. 71%; relative risk (RR) 0.89, 95% CI 0.73–1.09). Compared with the DARK group, patients from the LIGHT group were less likely to be intervened with antipsychotics for agitation episodes (13% vs. 25%; RR 0.52, 95% CI 0.27–0.98) and had less frequent hallucinations (11% vs. 22%; RR 0.49, 95% CI 0.24–0.98). In multivariate logistic regression analysis, natural light exposure was independently associated with a reduced risk of agitation episodes intervened with antipsychotics (adjusted odds ratio = 0.39; 95% CI 0.17–0.88).

Conclusion

Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However, natural light exposure was associated with a reduced risk of agitation episodes and hallucinations.

中文翻译：

---

自然光暴露对重症监护病房接受有创机械通气的成年患者妄负担的影响：一项前瞻性研究

客观的

为了确定在单个房间中入住ICU的重症患者，是否可能通过窗户暴露在自然光下是否与reduced妄负担减轻有关。

设计

前瞻性单中心研究。

环境

大学医院的医疗ICU，巴黎，法国。

耐心

成年患者接受有创机械通气。

方法

连续入院单人房（有光组）或没有（DARK组）通过窗户暴露在自然光下的连续患者的del妄进行了评估。主要终点是of妄的发生率。主要的次要研究终点包括严重躁动与抗精神病药物干预的发生以及幻觉的发生。

结果

总共包括195名患者（轻型组：n  = 110；深色组：n  = 85）。轻组和暗组的ir妄发生率相似（64％比71％；相对风险（RR）0.89，95％CI 0.73-1.09）。与DARK组相比，LIGHT组的患者较少因激动发作而接受抗精神病药物干预（13％vs. 25％； RR 0.52，95％CI 0.27-0.98），幻觉的发生率较低（11％vs. 11％）。 22％； RR 0.49，95％CI 0.24-0.98）。在多因素logistic回归分析中，自然光暴露与躁动发作和抗精神病药物干预风险的降低独立相关（调整后的优势比= 0.39； 95％CI 0.17–0.88）。

结论

与不带窗户的单人房相比，进入单人房并可能通过窗户暴露在自然光下不会减少ir妄负担。然而，自然光暴露与躁动发作和幻觉的风险降低相关。