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829: VIRTUAL REALITY IN THE PEDIATRIC ICU

Introduction/Hypothesis: Patients in the pediatric ICU (PICU) frequently have limitations that impede developmentally-typical play, social interactions, and exploration of their environments. In addition, many patients are at risk for lengthy hospital stays, associated with affective changes and delirium. Virtual reality (VR) is an immersive experience that may provide cognitively and emotionally stimulating experiences, ultimately improving the PICU stay for critically ill children. Methods: This was a prospective study of pediatric patients admitted to a large PICU at a single institution. Eligible patients included those on non-invasive or no respiratory support and those who were hemodynamically stable. Patients with neurologic injury, significant developmental or intellectual disorders, or significant visual impairment were excluded. Participants engaged in curated set of VR experiences for a duration of their choice. During VR, physiologic data (e.g., heart rate) were captured from the bedside monitor through BedMaster. In addition, investigators recorded behavioral observations using a standardized coding system that included participant instances of positive/negative facial expression and verbalizations. Participant engagement with VR was rated on an investigator-developed rating scale (1 = very minimal/absent engagement, 10 = total immersion/engagement). Following VR, participants and parents completed a brief survey. Results: Participants were 110 PICU patients (median age=10 years; IQR=6-13 years). They engaged with VR for a median of 11 minutes (IQR 7-17). The median number of positive comments made per participant was 1 (IQR 0-3); median number of negative comments was 0. Patients smiled a median of 3 times while using VR (IQR 1-5). Participant VR engagement was rated as high (median=9, IQR 8-10). Post-VR surveys showed that most patients enjoyed using VR (95% agreed/strongly agreed), wanted to use VR for longer periods of time (61%), wanted to use VR in the future (87%), and found that VR was a calming experience (79%). Analysis of physiologic data is in process. Conclusions: VR is an innovative tool that can be easily administered to many PICU patients, is enjoyable, and highly engages yet subjectively calms patients in an otherwise high-stimulus environment.