(108) A Novel Alternative Communication Device in Ventilated Patients: A Study on Its Effect on Delirium

Introduction: Communication in mechanically ventilated and/or tracheotomized patients may be very difficult, leading to anxiety and frustration and in turn increasing delirium. Existing technologies for bridging this gap are limited.
The EycontrolMed is a novel device that includes a camera to detect eye movements and a bone conduction headphone, allowing patients to receive voice messages, as well as interact with the device. A previous uncontrolled study of 15 ventilated patients showed improved communication and lower delirium rates. The objective of this study was to investigate the effect of the device on delirium compared with standard care.

Methods: This was a single center randomized, controlled study performed at the general ICU of a tertiary university-affiliated hospital. Patients were eligible if they were intubated/tracheotomized adults unable to generate speech with a RASS score between -3 and +1. The device arm received up to 7 days of device usage, 8 hours daily, receiving orientation messages, family messages, music/religious contents according to their preference and white noise. Delirium was quantitatively assessed using the CAM-ICU-7 tool. The control group received standard care without the device and underwent the same assessments.

Results: 60 patients were included after informed consent was obtained, 30 in each arm. CAM-ICU-7 scores decreased from baseline to the best examination by 3 points in the device arm and 2 points in the control group (p=0.098). CAM-ICU-7 decreased from baseline to the last examination by 2 points in the device arm and 1 point in the control arm (p=0.072). Looking only at patients aged 50 and above, CAM-ICU-7 scores decreased by 3 points vs. 2 points from baseline to the best (p=0.022) and by 3 points vs. 0 points from baseline to the last examination (p=0.007).

Conclusions: While not reaching statistical significance, there was a positive trend for decreased delirium in ventilated patients using the device, possibly due to the limited sample size. For patients above 50, there was a marked and significant improvement in delirium. The EyecontrolMed device is a potential aid for preventing and treating ICU delirium in ventilated patients. A larger multicenter study of patients above 50 is in progress to further assess the device's role in therapy.