Incidence of Intensive Care Unit Delirium After Heart Surgery: A Feasibility Study of a Forest Environment Intervention.
Jolana Wagner-Skacel, Michael Schörghuber, Christoph Kumpitsch et al.
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In 30 seconds
This randomized feasibility study evaluated forest-environment and light-exposure interventions, compared with standard care, in adults undergoing elective cardiac surgery at a tertiary ICU in Austria. The interventions were delivered for 12 hours daily, with feasibility and safety as primary aims and delirium assessed descriptively. Of 77 enrolled patients, 64 were included in the final analytical cohort. Delirium was detected in 5 of 130 completed CAM-ICU assessments (3.8%) and 8 of 115 completed ICDSC assessments (6.9%). The low detection rates prevented inferential comparisons between groups.
Key findings
- Seventy-seven patients were enrolled; 64 remained in the final analytical cohort.
- Delirium was detected in 5 of 130 completed CAM-ICU assessments (3.8%) and 8 of 115 completed ICDSC assessments (6.9%).
- Interventions were delivered within routine care, with no intervention-related adverse events or reported concerns.
- Operational constraints, patient transfers, and sedation or early discharge limited implementation and delirium assessments.
Why it matters
Environmental approaches that address light and other ICU conditions are of interest because postoperative delirium is a serious complication and ICU settings may disrupt circadian cues. This feasibility study suggests such interventions can be incorporated into routine care without reported safety concerns, while showing that logistics and incomplete assessments can complicate evaluation of delirium outcomes.
What to keep in mind
The unexpectedly low delirium incidence precluded inferential comparisons between groups. Assessments were incomplete at several time points, and implementation was affected by ICU logistics and pandemic-related disruptions.