by Roland Smonig, Eric Magalhaes, Lila Bouadma, Olivier
Andremont, Etienne de Montmollin, Fatiah Essardy, Bruno Mourvillier, Jordane
Lebut, Claire Dupuis, Mathilde Neuville, Mathilde Lermuzeaux, Jean-François
Timsit and Romain Sonneville
Annals of Intensive Care volume 9,
Article number: 120 (2019)
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.
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