Nursing in critical care
Incidence of Intensive Care Unit Delirium After Heart Surgery: A Feasibility Study of a Forest Environment Intervention
By Wagner-Skacel J, Schörghuber M, Kumpitsch C and 16 others.
Abstract
Background
Postoperative delirium is a serious complication in intensive care units (ICUs), particularly following cardiac surgery. It is associated with circadian rhythm disruption, sleep disturbances and adverse outcomes. ICU environments often lack natural time cues, which may exacerbate circadian misalignment and increase delirium risk.
Aim
The primary aim of the study was the evaluation of the implementation of two chronotherapeutic ICU interventions regarding recruitment, implementability and safety. Its secondary aim was to descriptively assess postoperative delirium across intervention groups.
Study design
This randomized feasibility study was conducted in a tertiary cardiac surgery ICU in Austria. Adult patients undergoing elective cardiac surgery were allocated to one of three groups: (1) forest environment, (2) light exposure or (3) standard ICU care. Interventions were applied for 12 h daily. Delirium was assessed at three postoperative time points using the confusion assessment method for the ICU (CAM-ICU) and intensive care delirium screening checklist (ICDSC).