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Mall A, Stokes J, Streisfeld G, Zychowicz M, Granger BB. Virtual Reality Strategies for Promoting Mobility in the Intensive Care Unit: A Case Report. AACN Adv Crit Care 2024; 35:238-243. [PMID: 39213631 DOI: 10.4037/aacnacc2024315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Prolonged bed rest is a known contributor to muscle atrophy, weakness, and deconditioning. Early active mobilization protocols aim to combat acquired weakness and loss of function in patients in the intensive care unit. Despite these benefits, mobilization of patients in the intensive care unit remains a challenge, most notably for patients with limited ability to get out of bed because of invasive devices and prolonged hospitalization. Virtual reality has gained favor for use in critical care to mitigate patients' stress, pain, and anxiety and to provide distraction and socialization. This case report demonstrates a novel application of virtual reality and the ease with which virtual reality can be used to facilitate early mobility and activity progression in the critically ill.
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Affiliation(s)
- Anna Mall
- Anna Mall is Clinical Nurse Specialist, Duke Heart Center, Duke University Hospital, 7605 Duke Hospital North, Durham, NC 27710
| | - Jason Stokes
- Jason Stokes is Assistant Nurse Manager, Duke University Hospital, Durham, North Carolina
| | - Gabriel Streisfeld
- Gabriel Streisfeld is Physical Therapist, Duke University Hospital, Durham, North Carolina
| | - Michael Zychowicz
- Michael Zychowicz is Professor, Duke University School of Nursing, Durham, North Carolina
| | - Bradi B Granger
- Bradi B. Granger is Professor, Duke University School of Nursing, and Director, Duke Heart Nursing Research Program, Duke University Health System, Durham, North Carolina
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2
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McAdams RM, Trinh G. Using Virtual Reality-Based Simulation in Neonatal Resuscitation Program Training. Neoreviews 2024; 25:e567-e577. [PMID: 39217132 DOI: 10.1542/neo.25-9-e567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/14/2024] [Accepted: 02/28/2024] [Indexed: 09/04/2024]
Abstract
In this article, we investigate the incorporation of virtual reality (VR) into Neonatal Resuscitation Program (NRP) training. We describe the potential advantages and challenges of the use of VR with NRP. We compare conventional training approaches to VR-based simulation, reviewing diverse VR platforms and their specific roles in neonatal resuscitation education. In addition, technological and ethical aspects in medical training, current research, and prospective developments in this innovative educational tool are discussed.
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Affiliation(s)
- Ryan M McAdams
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - GiaKhanh Trinh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Hixson R, Jensen KS, Melamed KH, Qadir N. Device associated complications in the intensive care unit. BMJ 2024; 386:e077318. [PMID: 39137947 DOI: 10.1136/bmj-2023-077318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Invasive devices are routinely used in the care of critically ill patients. Although they are often essential components of patient care, devices such as intravascular catheters, endotracheal tubes, and ventilators are a common source of complications in the intensive care unit. Critical care practitioners who use these devices need to use strategies for risk reduction and understand approaches to management when adverse events occur. This review discusses the identification, prevention, and management of complications of vascular, airway, and mechanical support devices commonly used in the intensive care unit.
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Affiliation(s)
- Roxana Hixson
- David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA, USA
| | - Kristin Schwab Jensen
- David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA, USA
| | - Kathryn H Melamed
- David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA, USA
| | - Nida Qadir
- David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA, USA
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4
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Locke BW, Tsai TY, Reategui-Rivera CM, Gabriel AS, Smiley A, Finkelstein J. Immersive Virtual Reality Use in Medical Intensive Care: Mixed Methods Feasibility Study. JMIR Serious Games 2024; 12:e62842. [PMID: 39046869 PMCID: PMC11344185 DOI: 10.2196/62842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Immersive virtual reality (VR) is a promising therapy to improve the experience of patients with critical illness and may help avoid postdischarge functional impairments. However, the determinants of interest and usability may vary locally and reports of uptake in the literature are variable. OBJECTIVE The aim of this mixed methods feasibility study was to assess the acceptability and potential utility of immersive VR in critically ill patients at a single institution. METHODS Adults without delirium who were admitted to 1 of 2 intensive care units were offered the opportunity to participate in 5-15 minutes of immersive VR delivered by a VR headset. Patient vital signs, heart rate variability, mood, and pain were assessed before and after the VR experience. Pre-post comparisons were performed using paired 2-sided t tests. A semistructured interview was administered after the VR experience. Patient descriptions of the experience, issues, and potential uses were summarized with thematic analysis. RESULTS Of the 35 patients offered the chance to participate, 20 (57%) agreed to partake in the immersive VR experience, with no difference in participation rate by age. Improvements were observed in overall mood (mean difference 1.8 points, 95% CI 0.6-3.0; P=.002), anxiety (difference of 1.7 points, 95% CI 0.8-2.7; P=.001), and pain (difference of 1.3 points, 95% CI 0.5-2.1; P=.003) assessed on 1-10 scales. The heart rate changed by a mean of -1.1 (95% CI -0.3 to -1.9; P=.008) beats per minute (bpm) from a baseline of 86.1 (SD 11.8) bpm and heart rate variability, assessed by the stress index (SI), changed by a mean of -5.0 (95% CI -1.5 to -8.5; P=.004) seconds-2 from a baseline SI of 40.0 (SD 23) seconds-2. Patients commented on the potential for the therapy to address pain, lessen anxiety, and facilitate calmness. Technical challenges were minimal and there were no adverse effects observed. CONCLUSIONS Patient acceptance of immersive VR was high in a mostly medical intensive care population with little prior VR experience. Patients commented on the potential of immersive VR to ameliorate cognitive and emotional symptoms. Investigators can consider integrating minimally modified commercial VR headsets into the existing intensive care unit workflow to further assess VR's efficacy for a variety of endpoints.
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Affiliation(s)
- Brian W Locke
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
- Department of Pulmonary and Critical Care, Intermountain Medical Center, Murray, UT, United States
| | - Te-Yi Tsai
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | | | - Aileen S Gabriel
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Aref Smiley
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Joseph Finkelstein
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
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5
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Xue F, Zhang R, Dai J, Zhang Y, Luan QX. Clinical application of mixed reality holographic imaging technology in scaling and root planing of severe periodontitis: a proof of concept. J Dent 2024; 149:105284. [PMID: 39122206 DOI: 10.1016/j.jdent.2024.105284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/25/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVES To demonstrate the potential application of mixed reality (MR) holographic imaging technology in subgingival scaling and root planing (SRP) for patient with advanced periodontitis. METHODS This case series comprised the analysis of 1566 sites from 261 teeth of 10 patients with advanced periodontitis. Digital CBCT scans and intraoral scans of the patients were digitally acquired preoperatively and aligned to create a three-dimensional periodontal visualization model. Through rendering, interactive holographic images were displayed using MR. The surgeon first used MR images to communicate with the patients, and then facilitated SRP under their guidance. Probing pocket depth (PPD), clinical attachment loss (CAL), Plaque index (PI), and bleeding on probing (BOP) parameters were recorded at baseline and at 8-week postoperatively. Patient-reported outcome indicator questionnaires on self-efficacy were also collected. RESULTS PPD, CAL, PI, and BOP significantly decreased at 8-week following MR hologram-assisted SRP (p<0.001). For sites with PPD≥4 mm, PPD and CAL declined by 2.33±1.23 mm and 0.69±1.07 mm, respectively. PI significantly decreased from 1.94±0.61 to 0.82±0.58 (p < 0.001) and BOP sites decreased significantly from 84.11% to 40.25%. After receiving MR holograms for condition communication, most patients had a better perception of the effectiveness of SRP treatment and the benefits it brings. 80% of the subjects expressed their willingness to undergo MR-assisted periodontal treatment in the future. CONCLUSION These results provide preliminary support for MR hologram-assisted digital SRP. With this technology, images of the gingiva and alveolar bone can be displayed in real time, accurately and three-dimensionally. This improves SRP effectiveness, diminishes complications, and enhances patients' confidence in the treatment. CLINICAL SIGNIFICANCE MR holographic imaging-based digital SRP is a clinically feasible and promising adjunctive periodontal treatment option. It may contribute to improved non-surgical treatment efficacy in patients with severe periodontitis.
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Affiliation(s)
- Fei Xue
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Rui Zhang
- Third Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Jun Dai
- Hefei VR-Sens Medical Technology Co., Ltd. Anhui, PR China
| | - Yong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, PR China.
| | - Qing-Xian Luan
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, PR China.
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Kanschik D, Haschemi J, Heidari H, Klein K, Afzal S, Maier O, Piayda K, Binneboesssel S, Oezaslan G, Bruno RR, Antoch G, Lichtenberg A, Fleissner F, Scherner M, Kelm M, Zeus T, Jung C. Feasibility, Accuracy, and Reproducibility of Aortic Valve Sizing for Transcatheter Aortic Valve Implantation Using Virtual Reality. J Am Heart Assoc 2024; 13:e034086. [PMID: 39041603 DOI: 10.1161/jaha.123.034086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/18/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Detailed visualization and precise measurements of aortic valve dimensions are critical for the success of transcatheter aortic valve implantation and for the prevention of complications. Currently, multislice computed tomography is the gold standard for assessment of the aortic annulus and surrounding structures to determine the prosthesis size. New technologies such as virtual reality (VR) not only enable 3-dimensional (3D) visualization with the potential to improve understanding of anatomy and pathology but also allow measurements in 3D. This study aims to investigate the feasibility, accuracy, and reproducibility of VR for the visualization of the aortic valve, the surrounding structures, and its role in preprocedural sizing for transcatheter aortic valve implantation. METHODS AND RESULTS Based on the preprocedural multislice computed tomography data, 3mensio measurements and 3D visualizations and measurements using VR software were performed retrospectively on 60 consecutive patients who underwent transcatheter aortic valve implantation at our heart center. There were no significant differences but strong correlations between the VR measurements compared with those performed with the 3mensio software. Furthermore, excellent or good intra- and interobserver reliability could be demonstrated for all values. In a structured questionnaire, users reported that VR simplified anatomical understanding, improved 3D comprehension of adjacent structures, and was associated with very good self-perceived depth perception. CONCLUSIONS The use of VR for preprocedural transcatheter aortic valve implantation sizing is feasible and has precise and reproducible measurements. In addition, 3D visualization improves anatomical understanding and orientation. To evaluate the potential benefits of 3D visualization for planning further cardiovascular interventions, research in this field is needed.
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Affiliation(s)
- Dominika Kanschik
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Jafer Haschemi
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Houtan Heidari
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Kathrin Klein
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Shazia Afzal
- Heartcenter Trier Krankenhaus der Barmherzigen Brueder Trier Germany
| | - Oliver Maier
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Kerstin Piayda
- Department of Cardiology and Angiology University Hospital Giessen und Marburg Giessen Germany
| | - Stephan Binneboesssel
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Goeksen Oezaslan
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Raphael R Bruno
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
- Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty Heinrich-Heine University Duesseldorf Germany
| | - Felix Fleissner
- Department of Cardiac Surgery, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Maximillian Scherner
- Department of Cardiac Surgery, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
- Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty Heinrich-Heine University Duesseldorf Germany
| | - Tobias Zeus
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
| | - Christian Jung
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Hospital and Heinrich-Heine University Duesseldorf Germany
- Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty Heinrich-Heine University Duesseldorf Germany
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7
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Fereidooni M, Toni E, Toni E, Ayatollahi H. Application of virtual reality for supportive care in cancer patients: a systematic review. Support Care Cancer 2024; 32:570. [PMID: 39103681 DOI: 10.1007/s00520-024-08763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/23/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND In recent years, virtual reality (VR) technology has been widely used to support cancer patients with physical, emotional, and functional needs. This systematic review aimed to investigate the application of VR in the supportive care of cancer patients. METHOD This systematic review was conducted in 2024. In this study, various databases including PubMed, Web of Science, Scopus, the Cochrane Library, Ovid, IEEE Xplore, and ProQuest were searched, and quantitative, qualitative, and mixed-method studies which were in English and published up to 20th May 2024 were included. The keywords consisted of "virtual reality," "supportive care," and "cancer". Studies were assessed in terms of quality and risk of bias using standard tools, and results were analyzed and reported narratively. RESULTS A total of 33 articles were reviewed. VR interventions, primarily using fully immersive head-mounted displays, were associated with significant reductions in anxiety, pain, and fatigue. VR also improved mood, relaxation, and overall quality of life, and some studies noted enhanced vital signs such as heart rate and blood pressure. This technology could be used along with other medical interventions. Both patients and healthcare providers reported high level of satisfaction with VR, and appreciated its ease of use and therapeutic benefits. However, some technical barriers, like inadequate visual performance and realism, were reported. CONCLUSION VR demonstrates substantial potential benefits as a supportive care tool for cancer patients, effectively addressing their psychological, physiological, psychosocial needs. Despite technical challenges, high level of user satisfaction and benefits underscore the need for further research to optimize VR interventions in cancer care.
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Affiliation(s)
- Mahsa Fereidooni
- Department of Health Information Technology, Urmia University of Medical Sciences, Urmia, Iran
| | - Esmaeel Toni
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
| | - Elham Toni
- Department of Health Information Management and Technology, Faculty of Management and Health Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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Cieślik B, Wrzeciono A, Mazurek J, Federico S, Szczepańska-Gieracha J, Kiper P. Balance Board or Motion Capture? A Meta-Analysis Exploring the Effectiveness of Commercially Available Virtual Reality Exergaming in Enhancing Balance and Functional Mobility Among the Elderly. Games Health J 2024. [PMID: 39093844 DOI: 10.1089/g4h.2023.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Force platforms and motion capture are commonly used as feedback mechanisms in exergaming; nevertheless, their therapeutic effectiveness may vary. Therefore, the primary objective of this study was to evaluate the effectiveness of commercially available virtual reality (VR) exergaming systems on balance and functional mobility, with a supplementary analysis considering the administered dose of exergaming. The search was conducted in five databases. Commercially available exergaming platforms were classified into two categories: VR exergaming with a balance board (including Wii Balance Board) and motion capture (including Xbox Kinect). Two categories of control interventions (treatment as usual [TAU] and no treatment [NT]) were extracted. The meta-analysis was performed separately for static, dynamic, and proactive balance outcomes and for the aggregated results of all included outcomes with subgroup analysis of lower, moderate, and higher doses. In total, 28 studies with 1457 participants were included. Both exergaming systems were particularly effective in improving the single leg stance outcome. VR exergaming with motion capture was found to be more effective than TAU with a standardized mean difference (SMD) of 0.48 (P = 0.006) and NT (SMD = 0.86; P = 0.02). In conclusion, commercially available VR exergaming with a motion capture feedback mechanism has demonstrated effectiveness as an intervention for balance training when compared with NT. Specifically, high doses (above 134 minutes per week) appear to be more beneficial for healthy older adults. Moreover, the findings provide some weak evidence supporting the effectiveness of VR exergaming with a balance board for improving functional mobility, particularly when compared with NT.
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Affiliation(s)
- Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Venezia, Italy
| | - Adam Wrzeciono
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Justyna Mazurek
- University Rehabilitation Centre, Wroclaw Medical University, Wroclaw, Poland
| | - Sara Federico
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Venezia, Italy
| | | | - Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Venezia, Italy
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Lou J, Li J, Fan Y, Zhang C, Huang N. Effects of Virtual Reality on Analgesia in Wound Care and Physical Therapy for Burn Patients: A Systematic Review and Meta-analysis. Pain Manag Nurs 2024; 25:377-388. [PMID: 38702259 DOI: 10.1016/j.pmn.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 02/17/2024] [Accepted: 03/04/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to determine the effectiveness of virtual reality (VR) in alleviating pain and improving the experience of burn patients during wound care and physical therapy. DESIGN A systematic review and meta-analysis. DATA SOURCES PubMed, Embase, the Cochrane Database, and the Web of Science. REVIEW/ANALYSIS METHODS We searched four electronic databases for randomized controlled trials (RCTs) published from the earliest available date up to March 1, 2022. The primary outcome was worst pain intensity, while secondary outcomes encompassed pain unpleasantness intensity, time spent thinking about pain, and fun experience intensity. Risk of bias was evaluated using the Cochrane Collaboration's tool. RESULTS This study included 21 trials. The combined data revealed that the VR group experienced a significant reduction in worst pain intensity, pain unpleasantness intensity, and time spent thinking about pain compared to the control group. Moreover, VR treatment was associated with a significant increase in the fun experience intensity. IMPLICATIONS FOR NURSING Virtual reality has the potential value of auxiliary analgesia in burn care, and exploring a more perfect scheme of VR-assisted analgesia is worthwhile. CONCLUSIONS The results of this meta-analysis indicate that VR can effectively reduce worst pain intensity, pain unpleasantness intensity, and time spent thinking about pain during wound care and physical therapy for burn patients. Additionally, it enhances fun experience intensity of the treatment period. Therefore, VR shows promise as a valuable complementary pain management intervention for burn patients.
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Affiliation(s)
- Jiaqi Lou
- Burn Department, Ningbo No. 2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang Province, China
| | - JiLiang Li
- Burn Department, Ningbo No. 2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang Province, China
| | - Youfen Fan
- Burn Department, Ningbo No. 2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang Province, China
| | - Chun Zhang
- Burn Department, Ningbo No. 2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang Province, China
| | - Neng Huang
- Burn Department, Ningbo No. 2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang Province, China.
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Levit T, Grzela P, Lavoie DCT, Wang L, Agarwal A, Couban RJ, Shanthanna H. The Effectiveness of Virtual and Augmented Reality in Surgical Pain Management: A Systematic Review of Randomized Controlled Trials. Anesth Analg 2024:00000539-990000000-00888. [PMID: 39088374 DOI: 10.1213/ane.0000000000007051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
BACKGROUND Satisfactory management of postoperative pain remains challenging. Nonpharmacological modalities such as virtual and augmented reality (VR/AR) offer potential benefits and are becoming increasingly popular. This systematic review evaluates the effectiveness and safety of VR/AR interventions on postoperative pain and recovery. METHODS MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL databases were searched from inception to July 27, 2023, for randomized controlled trials (RCTs), published in English, evaluating the use of VR/AR interventions for surgical pain relief. Study selection and data extraction were performed by pairs of reviewers independently and in duplicate, and potential risk of bias was determined using the Risk of Bias-version 2 (RoB 2) tool. Our outcomes included pain relief, reduction of anxiety, satisfaction, and adverse effects. Due to substantial heterogeneity, a narrative synthesis without meta-analysis was performed. RESULTS We included 35 trials among 2257 citations, categorized as surgery (n = 12), minor procedures (n = 15), and postoperative physiotherapy (n = 8). Surgical group included various surgeries, with 11 using immersive VR predominantly in the postoperative period, and most reporting no differences in pain, but potential for reduced anxiety and sedation requirements. In the minor procedures group, most studies reported decreased pain and anxiety during the procedural performance. Two studies reported increased heart rate, while 2 others reported better hemodynamic stability. Home-based AR physiotherapy achieved (n = 6) similar pain and functional outcomes after knee replacement, with 1 large study (n = 306) reporting reduction of mean costs by $2745 for provision of 12 weeks physiotherapy. There were some concerns around potential bias for most studies, as the nature of interventions make it challenging to blind assessors and participants. No important adverse effects were noted using VR/AR technology. CONCLUSIONS Evidence from RCTs indicates that the use of immersive VR during minor procedures may reduce procedural pain, decrease anxiety, and improve satisfaction. However, small studies, inconsistent effect, and variation in the application of interventions are important limitations. Evidence to support the application of AR/VR for major surgeries is limited and needs to be further investigated. Use of home-based physiotherapy with AR likely has economic advantages, and facilitates virtual care for appropriate patients who can access and use the technology safely.
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Affiliation(s)
- Tal Levit
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Grzela
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Declan C T Lavoie
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Li Wang
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Aashna Agarwal
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rachel J Couban
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Harsha Shanthanna
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
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Wang Y, Zhu M, Chen X, Liu R, Ge J, Song Y, Yu G. The application of metaverse in healthcare. Front Public Health 2024; 12:1420367. [PMID: 39135928 PMCID: PMC11317258 DOI: 10.3389/fpubh.2024.1420367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 07/10/2024] [Indexed: 08/15/2024] Open
Abstract
While metaverse is widely discussed, comprehension of its intricacies remains limited to a select few. Conceptually akin to a three-dimensional embodiment of the Internet, the metaverse facilitates simultaneous existence in both physical and virtual domains. Fundamentally, it embodies a visually immersive virtual environment, striving for authenticity, where individuals engage in real-world activities such as commerce, gaming, social interaction, and leisure pursuits. The global pandemic has accelerated digital innovations across diverse sectors. Beyond strides in telehealth, payment systems, remote monitoring, and secure data exchange, substantial advancements have been achieved in artificial intelligence (AI), virtual reality (VR), augmented reality (AR), and blockchain technologies. Nevertheless, the metaverse, in its nascent stage, continues to evolve, harboring significant potential for revolutionizing healthcare. Through integration with the Internet of Medical Devices, quantum computing, and robotics, the metaverse stands poised to redefine healthcare systems, offering enhancements in surgical precision and therapeutic modalities, thus promising profound transformations within the industry.
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Affiliation(s)
- Yue Wang
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Mengying Zhu
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
- Department of Clinical Integration of Traditional Chinese and Western Medicine, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Xi Chen
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
- Department of Clinical Integration of Traditional Chinese and Western Medicine, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Ruibin Liu
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
- Department of Clinical Integration of Traditional Chinese and Western Medicine, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Jinnian Ge
- Department of General Surgery, First Hospital of China Medical University, Shenyang, China
| | - Yuxuan Song
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
- Pharmaceutical Science, China Medical University-The Queen’s University Belfast Joint College, Shenyang, China
| | - Guilin Yu
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
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Haghedooren E, Haghedooren R, Langer D, Gosselink R. Feasibility and safety of interactive virtual reality upper limb rehabilitation in patients with prolonged critical illness. Aust Crit Care 2024:S1036-7314(24)00117-6. [PMID: 39054204 DOI: 10.1016/j.aucc.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES This study investigated the feasibility and safety of interactive virtual reality rehabilitation (VRR) for patients with a critical illness and a long stay in the intensive care unit (ICU), as a motivational tool for rehabilitation. DESIGN Single-centre, non-randomised proof-of-concept clinical trial. PARTICIPANTS Adult, calm, and alert critically ill patients with a prolonged stay (≥8 days) in the ICU. METHODS Patients received interactive VRR therapy for upper limb rehabilitation with a VR-app designed specifically for use in bedridden patients in the supine position. Feasibility was assessed by time registrations, questionnaires for patients and physiotherapists, as well as recording of all perceived barriers. Safety was assessed by recording (changes in) vital clinical parameters, as well as minor and major adverse events. RESULTS Twenty patients participated in 79 VRR sessions. Median durations of different session components were 2 minutes (interquartile range [IQR] = 2min, 3min) for set-up and explanation to the patient, 10 minutes (IQR = 10min, 15min) for training time, and 2 minutes (IQR = 2min, 2min) for ending the session and cleaning. The median fun score given by the patients after each session was 9 (IQR = 8, 10) out of 10. Physiotherapists reported no barriers other than a few time-consuming technical problems. Reported problems by patients were all minor and mostly technical. No major and no minor adverse events occurred. CONCLUSIONS Interactive upper limb VRR is a feasible, safe, and appreciated tool to use in rehabilitation of critically ill patients during their prolonged ICU stay. Subsequent future studies should focus on the effects of VRR on neuromuscular and cognitive function and the socioeconomic impact of exergaming for rehabilitation purposes of ICU patients.
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Affiliation(s)
- Eline Haghedooren
- KU Leuven, Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium; University Hospitals of KU Leuven, Department of Intensive Care Medicine, Leuven, Belgium.
| | - Renata Haghedooren
- University Hospitals of KU Leuven, Department of Intensive Care Medicine, Leuven, Belgium
| | - Daniel Langer
- KU Leuven, Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium; University Hospitals of KU Leuven, Department of Intensive Care Medicine, Leuven, Belgium
| | - Rik Gosselink
- KU Leuven, Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium; University Hospitals of KU Leuven, Department of Intensive Care Medicine, Leuven, Belgium
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Mergen M, Graf N, Meyerheim M. Reviewing the current state of virtual reality integration in medical education - a scoping review. BMC MEDICAL EDUCATION 2024; 24:788. [PMID: 39044186 PMCID: PMC11267750 DOI: 10.1186/s12909-024-05777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula. METHODS This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR. RESULTS A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages. DISCUSSION Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements.
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Affiliation(s)
- Marvin Mergen
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Saarland University, Building 9, Kirrberger Strasse 100, 66421, Homburg, Germany.
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Saarland University, Building 9, Kirrberger Strasse 100, 66421, Homburg, Germany
| | - Marcel Meyerheim
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Saarland University, Building 9, Kirrberger Strasse 100, 66421, Homburg, Germany
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Brungardt A, Wibben A, Shanbhag P, Boeldt D, Youngwerth J, Tompkins A, Rolbiecki AJ, Coats H, LaGasse AB, Kutner JS, Lum HD. Patient Outcomes of a Virtual Reality-Based Music Therapy Pilot in Palliative Care. Palliat Med Rep 2024; 5:278-285. [PMID: 39070962 PMCID: PMC11271146 DOI: 10.1089/pmr.2024.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 07/30/2024] Open
Abstract
Background Hospitalized patients with palliative care needs often have high levels of physical and psychological symptom distress. Virtual reality (VR) with a music therapy intervention may improve physical and psychological symptoms. Objectives To assess symptom distress and quality of life (QOL) among hospitalized palliative care patients who participated in a virtual reality-based music therapy (VR-MT) intervention, and to explore VR-MT from the perspectives of health care professionals involved in their care. Design Single-arm pilot study of a two-day VR-MT intervention. Setting/Participants Patients seen by an inpatient palliative care consultation service at a U.S. hospital could participate in the VR-MT intervention. Participants created a customized soundtrack with a music therapist and then listened to it while experiencing a 360-degree VR nature-based environment of their choice. Measurements Patients completed the Edmonton Symptom Assessment System, revised version (ESAS-r) and McGill Quality of Life, revised version (MQOL-R) before and after VR-MT. Members of the participants' health care teams were interviewed. Results Seventeen patients completed VR-MT (range 20-79 years of age, 59% women). Moderate clinical improvements were observed for total ESAS-r score (Cohen's d effect size, 0.68), physical distress subscale (0.52), and psychological distress subscale (0.60); small improvements were observed in total MQOL-r score (0.26) and the existential subscale (0.27). Health care team members described the value of VR-MT as facilitating meaningful conversations. Conclusions This pilot study of VR combined with a music therapy intervention for hospitalized patients with palliative care needs supports opportunities for future study of potential improvements in symptom distress and QOL.
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Affiliation(s)
- Adreanne Brungardt
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Angela Wibben
- University of Colorado Hospital Palliative Care Consult Service, University of Colorado Hospital, Aurora, Colorado, USA
| | - Prajakta Shanbhag
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Debra Boeldt
- National Mental Health Innovation Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jeanie Youngwerth
- University of Colorado Hospital Palliative Care Consult Service, University of Colorado Hospital, Aurora, Colorado, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Amanda Tompkins
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Abigail J. Rolbiecki
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Heather Coats
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - A. Blythe LaGasse
- School of Music, Theatre and Dance, Colorado State University, Fort Collins, Colorado, USA
| | - Jean S. Kutner
- University of Colorado Hospital Palliative Care Consult Service, University of Colorado Hospital, Aurora, Colorado, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Hillary D. Lum
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Yari A, Fasih P, Goodarzi A, Nouralishahi A, Nikeghbal D. The effect of augmented reality book on the proficiency of local anesthesia administration of the inferior alveolar nerve. J Dent Educ 2024; 88:1000-1008. [PMID: 38551219 DOI: 10.1002/jdd.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/15/2024] [Accepted: 03/03/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND/OBJECTIVE Advancements in augmented reality (AR) technology enable developers to create augmented reality books (AR Books). AR Books can show interactive 3D objects and multimedia content to the user. The purpose of this study was to investigate the effect of a developed AR Book on the theoretical and practical abilities in the administration of local anesthesia of the inferior alveolar nerve block. METHODS An exclusive AR Book was developed based on Chapter 14, Handbook of Local Anesthesia, seventh edition, Stanley F. Malamed, which enabled students to use their book (printed or electronic) as an AR Book. Forty dental students were randomly divided into control and study groups. In the control group, students were asked to use regular books, while in the study group, students were instructed to use interactive AR Books. All students took the written exam, scoring 0 to 10. Also, the administration of mandibular local anesthesia was evaluated in students. The level of concentration during the study, the written exam score, the practical score, the success rate of local anesthesia, and the needed time for injection were compared between the two groups. RESULTS There was a significant difference in the level of concentration during the study (p < 0.001), practical skill score (p = 0.037), and needed time for injection (p = 0.040) between the two groups. Conversely, the success rate of local anesthesia was almost similar (p = 0.705). Although the written exam score was higher in the study group than in the control group, the difference was not significant (p = 0.414). CONCLUSION Using AR Books can engage students and help them to remain focused during the study. AR Books may be beneficial in enhancing the practical abilities of dental students.
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Affiliation(s)
- Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Paniz Fasih
- Department of Prosthodontics, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Goodarzi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atieh Nouralishahi
- Sub-Department of Operations and Analytics, Department of Management, Faculty of Environment, Science and Economy, University of Exeter, Exeter, UK
| | - Dorsa Nikeghbal
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Vallée A, Arutkin M. The Transformative Power of Virtual Hospitals for Revolutionising Healthcare Delivery. Public Health Rev 2024; 45:1606371. [PMID: 38962359 PMCID: PMC11221308 DOI: 10.3389/phrs.2024.1606371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Objectives: The objective of this narrative review is to explore the advantages and limitations of VHs in delivering healthcare, including access to specialized professionals, streamlined communication, efficient scheduling, integration of electronic health records, ongoing monitoring, and support, transcending geographical boundaries, and resource optimization. Methods: Review of literature. Results: The national healthcare systems are facing an alarming rise in pressure due to global shifts. Virtual hospitals (VH) offer a practical solution to numerous systemic challenges, including rising costs and increased workloads for healthcare providers. VH also facilitate the delivery of personalized services and enable the monitoring of patients beyond the conventional confines of healthcare settings, reducing the reliance on waiting medicine carried out in doctors' offices or hospitals. Conclusion: VH can mirror the conventional healthcare referral system.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
| | - Maxence Arutkin
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
- School of Chemistry, Center for the Physics and Chemistry of Living Systems, Tel Aviv University, Tel Aviv-Yafo, Israel
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Li Q, Yang Z, Liu X, Zhang Q, Li M, Hu R, Huang L, Yu Q, Dai M. Perioperative use of immersive head-mounted virtual reality display enhances patient satisfaction in great saphenous vein surgery: a single-center clinical observation study. Am J Transl Res 2024; 16:2445-2452. [PMID: 39006251 PMCID: PMC11236645 DOI: 10.62347/kose3119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/24/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To explore the application effect of head-mounted virtual reality display immersive experience in improving the perioperative satisfaction of patients undergoing great saphenous vein surgery. METHODS A total of 158 patients undergoing saphenous vein surgery at the First Affiliated Hospital, Jiangxi Medical College, Nanchang University from January 2020 to January 2023 were randomly divided into an observation group and a control group in a 1:1 ratio, with 79 cases in each group. The observation group received head-mounted display virtual reality immersive experience, whereas the control group received midazolam. The study compared the perioperative satisfaction, changes in preoperative and postoperative anxiety and depression scores, intraoperative blood pressure and heart rate, postoperative visual analog scale (VAS) score, and the incidence of postoperative nausea and vomiting between the two groups. Additionally, the satisfaction of patients, anesthesiologists, and chief surgeons was compared. RESULTS All surgeries were completed successfully. Patients in the observation group exhibited higher perioperative satisfaction compared to those in the control group (P<0.001). There were no significant differences in anxiety or depression scores between the two groups before surgery (P>0.05). However, both groups showed a reduction in anxiety and depression scores postoperatively, with the observation group demonstrating lower scores than the control group (both P<0.05). The observation group also had lower intraoperative blood pressure, heart rate, postoperative VAS scores, and incidence of nausea and vomiting compared to the control group (all P<0.05). Furthermore, the satisfaction levels of the anesthesiologists and chief surgeons were higher in the observation group than in the control group (P=0.043, 0.012). CONCLUSION Head-mounted display virtual reality immersive experience can enhance perioperative satisfaction among patients undergoing great saphenous vein surgery, reduce anxiety and depression scores, and contribute to the stabilization of hemodynamics during surgery, thereby decreasing postoperative nausea and vomiting.
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Affiliation(s)
- Qianqian Li
- Department of Anesthesiology and Operative Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Zichang Yang
- Department of The First Clinical Medical College, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Xuyang Liu
- Department of The First Clinical Medical College, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Qin Zhang
- Department of Anesthesiology and Operative Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Mengyuan Li
- Department of Anesthesiology and Operative Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Ruilin Hu
- Department of General Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Lianghui Huang
- Department of General Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Qi Yu
- Department of Anesthesiology and Operative Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
| | - Min Dai
- Department of General Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330052, Jiangxi, China
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Broch Porcar MJ, Castellanos-Ortega Á. Patient safety, what does clinical simulation and teaching innovation contribute? Med Intensiva 2024:S2173-5727(24)00101-2. [PMID: 38797620 DOI: 10.1016/j.medine.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/24/2024] [Indexed: 05/29/2024]
Abstract
Clinical simulation in Intensive Care Medicine is a crucial tool to strengthen patient safety. It focuses on the complexity of the Intensive Care Unit, where challenging clinical situations require rapid decision making and the use of invasive techniques that can increase the risk of errors and compromise safety. Clinical simulation, by mimicking clinical contexts, is presented as essential for developing technical and non-technical skills and enhancing teamwork in a safe environment, without harm to the patient. in situ simulation is a valuable approach to practice in realistic environments and to address latent security threats. Other simulation methods as virtual reality and tele-simulation are gaining more and more acceptance. Herein, we provide current data on the clinical utility of clinical simulation related to improved safety in the practice of techniques and procedures, as well as improvements of teamwork performance and outcomes. Finally, we propose the needs for future research.
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Longo UG, Lalli A, Gobbato B, Nazarian A. Metaverse, virtual reality and augmented reality in total shoulder arthroplasty: a systematic review. BMC Musculoskelet Disord 2024; 25:396. [PMID: 38773483 PMCID: PMC11106997 DOI: 10.1186/s12891-024-07436-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/11/2024] [Indexed: 05/23/2024] Open
Abstract
PURPOSE This systematic review aims to provide an overview of the current knowledge on the role of the metaverse, augmented reality, and virtual reality in reverse shoulder arthroplasty. METHODS A systematic review was performed using the PRISMA guidelines. A comprehensive review of the applications of the metaverse, augmented reality, and virtual reality in in-vivo intraoperative navigation, in the training of orthopedic residents, and in the latest innovations proposed in ex-vivo studies was conducted. RESULTS A total of 22 articles were included in the review. Data on navigated shoulder arthroplasty was extracted from 14 articles: seven hundred ninety-three patients treated with intraoperative navigated rTSA or aTSA were included. Also, three randomized control trials (RCTs) reported outcomes on a total of fifty-three orthopedics surgical residents and doctors receiving VR-based training for rTSA, which were also included in the review. Three studies reporting the latest VR and AR-based rTSA applications and two proof of concept studies were also included in the review. CONCLUSIONS The metaverse, augmented reality, and virtual reality present immense potential for the future of orthopedic surgery. As these technologies advance, it is crucial to conduct additional research, foster development, and seamlessly integrate them into surgical education to fully harness their capabilities and transform the field. This evolution promises enhanced accuracy, expanded training opportunities, and improved surgical planning capabilities.
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Affiliation(s)
- Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy.
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, Roma, 00128, Italy.
| | - Alberto Lalli
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, Roma, 00128, Italy
| | - Bruno Gobbato
- Department of Orthopaedic Surgery, Hospital Sao Jose Jaraguá do Sul, Jaraguá, SC, 89251-830, Brazil
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Trebuian CI, Brici OM, Sutoi D, Popa DI, Chioibas DR, Mederle OA. Lactate Levels and Clearance: Key Predictors of Prognosis for COVID-19 and Non-COVID-19 Septic Shock Patients in the Emergency Department. Clin Pract 2024; 14:834-845. [PMID: 38804397 PMCID: PMC11130935 DOI: 10.3390/clinpract14030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND This investigation assesses the prognostic value of lactate levels and their clearance in septic shock patients, particularly emphasizing the comparative analysis between COVID-19 and non-COVID-19 patients in the emergency department. This study aims to elucidate the unique prognostic implications of lactate dynamics in these distinct patient groups, thereby enhancing the management of septic shock. METHODS An observational prospective study was conducted, enrolling 114 septic shock patients from the Emergency County Hospital Resita, Romania, categorizing them into COVID-19 and non-COVID-19 groups to examine their initial lactate levels, clearance rates, and their correlation with patient outcomes. RESULTS This study identified significant differences in the initial lactate levels and clearance rates between the two groups, indicating higher initial lactate levels and slower clearance rates in COVID-19 patients. Survivors demonstrated significantly lower initial lactate levels (1.5 ± 0.4 mmol/L) and higher lactate clearance rates (33 ± 15%) compared to non-survivors (2.5 ± 0.5 mmol/L and 24 ± 9%, respectively; lactate levels p = 0.001, clearance rates p = 0.002). CONCLUSIONS Lactate monitoring, particularly clearance rates, is crucial in the prognostic assessment of septic shock patients. These findings highlight the need for targeted interventions in COVID-19 patients to improve outcomes, underscoring lactate dynamics as a vital component of septic shock management in differing patient populations.
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Affiliation(s)
- Cosmin Iosif Trebuian
- Department of Surgery I, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania; (C.I.T.); (D.S.); (D.R.C.); (O.A.M.)
| | - Octavia Maria Brici
- Department of Doctoral Studies, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Dumitru Sutoi
- Department of Surgery I, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania; (C.I.T.); (D.S.); (D.R.C.); (O.A.M.)
| | - Daian Ionel Popa
- Department of Doctoral Studies, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Daniel Raul Chioibas
- Department of Surgery I, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania; (C.I.T.); (D.S.); (D.R.C.); (O.A.M.)
| | - Ovidiu Alexandru Mederle
- Department of Surgery I, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania; (C.I.T.); (D.S.); (D.R.C.); (O.A.M.)
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Heidari H, Kanschik D, Maier O, Wolff G, Brockmeyer M, Masyuk M, Bruno RR, Polzin A, Erkens R, Antoch G, Reinartz SD, Werner N, Kelm M, Zeus T, Afzal S, Jung C. A comparison of conventional and advanced 3D imaging techniques for percutaneous left atrial appendage closure. Front Cardiovasc Med 2024; 11:1328906. [PMID: 38596690 PMCID: PMC11002144 DOI: 10.3389/fcvm.2024.1328906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/15/2024] [Indexed: 04/11/2024] Open
Abstract
Background Understanding complex cardiac anatomy is essential for percutaneous left atrial appendage (LAA) closure. Conventional multi-slice computed tomography (MSCT) and transesophageal echocardiography (TEE) are now supported by advanced 3D printing and virtual reality (VR) techniques for three-dimensional visualization of volumetric data sets. This study aimed to investigate their added value for LAA closure procedures. Methods Ten patients scheduled for interventional LAA closure were evaluated with MSCT and TEE. Patient-specific 3D printings and VR models were fabricated based on MSCT data. Ten cardiologists then comparatively assessed LAA anatomy and its procedure relevant surrounding structures with all four imaging modalities and rated their procedural utility on a 5-point Likert scale questionnaire (from 1 = strongly agree to 5 = strongly disagree). Results Device sizing was rated highest in MSCT (MSCT: 1.9 ± 0.8; TEE: 2.6 ± 0.9; 3D printing: 2.5 ± 1.0; VR: 2.5 ± 1.1; p < 0.01); TEE, VR, and 3D printing were superior in the visualization of the Fossa ovalis compared to MSCT (MSCT: 3.3 ± 1.4; TEE: 2.2 ± 1.3; 3D printing: 2.2 ± 1.4; VR: 1.9 ± 1.3; all p < 0.01). The major strength of VR and 3D printing techniques was a superior depth perception (VR: 1.6 ± 0.5; 3D printing: 1.8 ± 0.4; TEE: 2.9 ± 0.7; MSCT: 2.6 ± 0.8; p < 0.01). The visualization of extracardiac structures was rated less accurate in TEE than MSCT (TEE: 2.6 ± 0.9; MSCT: 1.9 ± 0.8, p < 0.01). However, 3D printing and VR insufficiently visualized extracardiac structures in the present study. Conclusion A true 3D visualization in VR or 3D printing provides an additional value in the evaluation of the LAA for the planning of percutaneous closure. In particular, the superior perception of depth was seen as a strength of a 3D visualization. This may contribute to a better overall understanding of the anatomy. Clinical studies are needed to evaluate whether a more comprehensive understanding through advanced multimodal imaging of patient-specific anatomy using VR may translate into improved procedural outcomes.
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Affiliation(s)
- Houtan Heidari
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Dominika Kanschik
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Oliver Maier
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Georg Wolff
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Maximilian Brockmeyer
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Maryna Masyuk
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Raphael Romano Bruno
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Amin Polzin
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Ralf Erkens
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Sebastian Daniel Reinartz
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Nikos Werner
- Department of Cardiology, Heartcenter Trier, Krankenhaus der Barmherzigen Brüder, Trier, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
- CARID (Cardiovascular Research Institute Düsseldorf), Düsseldorf, Germany
| | - Tobias Zeus
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - Shazia Afzal
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
- Department of Cardiology, Heartcenter Trier, Krankenhaus der Barmherzigen Brüder, Trier, Germany
| | - Christian Jung
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
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22
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Pulumati A, Algarin YA, Jaalouk D, Hirsch M, Nouri K. Exploring the potential role for extended reality in Mohs micrographic surgery. Arch Dermatol Res 2024; 316:67. [PMID: 38194123 DOI: 10.1007/s00403-023-02804-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/03/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024]
Abstract
Mohs micrographic surgery (MMS) is a cornerstone of dermatological practice. Virtual reality (VR) and augmented reality (AR) technology, initially used for entertainment, have entered healthcare, offering real-time data overlaying a surgeon's view. This paper explores potential applications of VR and AR in MMS, emphasizing their advantages and limitations. We aim to identify research gaps to facilitate innovation in dermatological surgery. We conducted a PubMed search using the following: "augmented reality" OR "virtual reality" AND "Mohs" or "augmented reality" OR "virtual reality" AND "surgery." Inclusion criteria were peer-reviewed articles in English discussing these technologies in medical settings. We excluded non-peer-reviewed sources, non-English articles, and those not addressing these technologies in a medical context. VR alleviates patient anxiety and enhances patient satisfaction while serving as an educational tool. It also aids physicians by providing realistic surgical simulations. On the other hand, AR assists in real-time lesion analysis, optimizing incision planning, and refining margin control during surgery. Both of these technologies offer remote guidance for trainee residents, enabling real-time learning and oversight and facilitating synchronous teleconsultations. These technologies may transform dermatologic surgery, making it more accessible and efficient. However, further research is needed to validate their effectiveness, address potential challenges, and optimize seamless integration. All in all, AR and VR enhance real-world environments with digital data, offering real-time surgical guidance and medical insights. By exploring the potential integration of these technologies in MMS, our study identifies avenues for further research to thoroughly understand the role of these technologies to redefine dermatologic surgery, elevating precision, surgical outcomes, and patient experiences.
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Affiliation(s)
- Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
| | | | - Dana Jaalouk
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Melanie Hirsch
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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23
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Rudschies C, Schneider I. Ethical, legal, and social implications (ELSI) of virtual agents and virtual reality in healthcare. Soc Sci Med 2024; 340:116483. [PMID: 38064822 DOI: 10.1016/j.socscimed.2023.116483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
Virtual agents (VAs) and immersive virtual reality (VR) applications broaden the opportunities for accessing healthcare by transposing certain processes from the analogue world into a virtual realm. While these innovations offer a number of advantages including improved access for individuals in diverse geographic locations and novel therapeutic options, their implementation raises significant ethical, social, and legal implications. Key considerations pertain to the doctor-patient relationship, privacy and data protection, justice, fairness, and equal access as well as to issues of accountability, liability, and safety. This paper conducts a comprehensive review of the existing literature to analyse the ethical, social, and legal ramifications of employing VAs and VR applications in healthcare. It examines the recommended strategies to mitigate potential adverse effects and addresses current research gaps in this domain.
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Affiliation(s)
- Catharina Rudschies
- Universität Hamburg, Department of Informatics, Vogt-Kölln-Straße 30, 22527, Hamburg, Germany.
| | - Ingrid Schneider
- Universität Hamburg, Department of Informatics, Vogt-Kölln-Straße 30, 22527, Hamburg, Germany.
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24
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Muralidharan V, Tran MM, Barrios L, Beams B, Ko JM, Siegel DH, Bailenson J. Best Practices for Research in Virtual and Augmented Reality in Dermatology. J Invest Dermatol 2024; 144:17-23. [PMID: 38105083 DOI: 10.1016/j.jid.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/19/2023]
Abstract
Virtual reality (VR) and augmented reality (AR) technologies have advanced rapidly in recent years. These cutting-edge technologies provide dermatology researchers, educators, proceduralists, and patients with opportunities in new scientific horizons. VR is a technology that facilitates immersive human experiences by allowing users to connect with various simulated environments through natural head and hand movements, whereas AR supplements a user's perception of their real environment with virtual elements. Despite technological advancements, there is limited literature on the methodological steps for conducting rigorous VR and AR research in dermatology. Effective storyboarding, user-driven design, and interdisciplinary teamwork play a central role in ensuring that VR/AR applications meet the specific needs of dermatology clinical and research teams. We present a step-by-step approach for their design, team composition, and evaluation in dermatology research, medical education, procedures, and habit formation strategies. We also discuss current VR and AR dermatology applications and the importance of ethical and safety considerations in deploying this new technology.
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Affiliation(s)
- Vijaytha Muralidharan
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA.
| | - Megan M Tran
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Laurel Barrios
- School of Medicine, University of California Davis, Davis, California
| | - Brian Beams
- Stanford Virtual Human Interaction Lab, Stanford, California, USA
| | - Justin M Ko
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA
| | - Dawn H Siegel
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA
| | - Jeremy Bailenson
- Stanford Virtual Human Interaction Lab, Stanford, California, USA
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25
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Joshi MK. Novel teaching-learning and assessment tools to complement competency-based medical education in postgraduate training. Indian J Anaesth 2024; 68:11-16. [PMID: 38406330 PMCID: PMC10893807 DOI: 10.4103/ija.ija_1175_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/01/2024] [Accepted: 01/07/2024] [Indexed: 02/27/2024] Open
Abstract
Medical and educational techniques and approaches have evolved globally over the past few decades. The modern approach is more learner-centred, with a focus on the acquisition of skills. The recently implemented competency-based medical education (CBME) for the National Medical Commission (NMC) undergraduate course curriculum is also competency-based rather than an outcome-based traditional curriculum. It is vital to embrace innovative teaching-learning and educational strategies to achieve the aspiration of CBME. This article provides a list of some of the newer tools and their perceived advantages and challenges and serves as a guide for using these methods effectively to meet the objectives of CBME as proposed by the NMC. Virtual teaching, learning from digital resources, objective-structured practical and clinical examination, flipped classroom, case-based learning, serious gaming, simulation-based learning and learning from role-plays and portfolios emerged as novel instructional strategies.
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Affiliation(s)
- Mohit K. Joshi
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
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26
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Coduri M, Calandrino A, Addiego Mobilio G, Casadio M, Ricci S. RiNeo MR: A mixed reality simulator for newborn life support training. PLoS One 2023; 18:e0294914. [PMID: 38128019 PMCID: PMC10734996 DOI: 10.1371/journal.pone.0294914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
Neonatal resuscitation is an uncommon, albeit critical task that is more likely to succeed if performed properly and promptly. In this context, simulation is an appropriate way for training and assessing the abilities of all medical staff involved in delivery room care. Recent studies have shown that learning is enhanced if the simulation experience is realistic and engaging. Hence, Virtual Reality can be beneficial for newborn resuscitation training. However, the difficulty of providing realistic haptic interaction limits its use. To overcome this constraint, we have designed RiNeo MR, a simulator for newborn life support training, combining a sensorized manikin to monitor in real time resuscitation skills, with a Virtual Reality application. The system includes a Virtual Reality headset, Leap Motion to track the user's hands, sensorized bag valve mask, and manikin to monitor head and mask positioning, ventilation, and chest compression. RiNeo MR can be used in two modalities: 2D to let the trainee practice resuscitation manoeuvres on the physical manikin, while receiving real time feedback; 3D that allows the user to be immersed in a virtual environment and practice in an hospital-like setting. In the 3D mode, virtual and real manikins are overlapped and communicate in real time. Tests on 16 subjects (11 controls without medical expertise and 5 paediatric residents) demonstrated that the simulator is well tolerated in terms of discomfort. Moreover, the simulator is high rated for user experience and system usability, suggesting that RiNeo MR can be a promising tool to improve newborn life support training. RiNeo MR is a proof of concept of a mixed-reality newborn life support simulator that can be a promising tool to spread newborn resuscitation high-quality training among healthcare providers involved in perinatal medicine.
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Affiliation(s)
- Mara Coduri
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- Simulation and Advanced Education Center - SimAv, University of Genoa, Genoa, Italy
| | - Andrea Calandrino
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Neonatal Intensive Care Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Giulia Addiego Mobilio
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Maura Casadio
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- Simulation and Advanced Education Center - SimAv, University of Genoa, Genoa, Italy
| | - Serena Ricci
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- Simulation and Advanced Education Center - SimAv, University of Genoa, Genoa, Italy
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27
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Wang Y, Li C, Qu L, Cai H, Ge Y. Application and challenges of a metaverse in medicine. Front Robot AI 2023; 10:1291199. [PMID: 38152305 PMCID: PMC10752600 DOI: 10.3389/frobt.2023.1291199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Metaverse has been confirmed as a relatively amorphous concept of innovation, which refers to technological advancement. Metaverse, i.e., a coalition between reality world and virtual world, has created significant significance and convenience in education, communication, economy, etc. The COVID-19 outbreak has stimulated the growth of metaverse applications in medicine. The above-mentioned technology has broad applications while comprising online remote medical treatment, online conferences, medical education, preparation of surgical plans, etc. Moreover, technical, security, and financial challenges should be tackled down by the future widespread use of metaverse. Metaverse is limitlessly promising, and it will exert a certain effect on future scientific and technological advancements in the medical industry. The review article primarily aims to summarize the application of the metaverse in medicine and their challenge in the future of medicine.
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Affiliation(s)
- Yingshu Wang
- College of Art, Changchun University of Technology, Changchun, Jilin, China
| | - Congcong Li
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lai Qu
- Department of Critical Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hongfei Cai
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yingying Ge
- College of Art, Changchun University of Technology, Changchun, Jilin, China
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28
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Parco C, Kreuels V, Kelm M, Jung C, Wolff G. Robotic-assisted early mobilization and virtual reality: a perspective on innovative support strategies for critically ill patients. Intensive Care Med Exp 2023; 11:86. [PMID: 38052739 DOI: 10.1186/s40635-023-00571-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/26/2023] [Indexed: 12/07/2023] Open
Affiliation(s)
- Claudio Parco
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Vanessa Kreuels
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf, Medical Faculty and University Hospital Düsseldorf, CARID, Heinrich-Heine-University, Düsseldorf, Germany
| | - Christian Jung
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Georg Wolff
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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29
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Jöbges S, Meier S. [News in intensive care unit communication]. Dtsch Med Wochenschr 2023; 148:1443-1447. [PMID: 37918429 DOI: 10.1055/a-1947-9612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Current publications on the topic of communication in intensive care units (ITS) are shaped by the experiences of the COVID19 pandemic and the restrictions on personal contact and communication experienced during this time. Virtual, computer-based and telemedical concepts have grown out of this situation with limited contact and communication possibilities with patients and their relatives, but also between the individual service providers in the health system. It can also be assumed that artificial intelligence will increasingly be an issue in communication in intensive care units in the coming years. However, the significance, consequences and risks of the use of these new possibilities remain to be seen.
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Affiliation(s)
- Susanne Jöbges
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charite, Universitätsmedizin Berlin
| | - Stefan Meier
- Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
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30
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Hsu NC, Liao C, Hsu CH. Proportions and trends of critical care trials in leading general medical journals, 1970-2022. Crit Care 2023; 27:375. [PMID: 37773187 PMCID: PMC10540386 DOI: 10.1186/s13054-023-04666-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/26/2023] [Indexed: 10/01/2023] Open
Affiliation(s)
- Nin-Chieh Hsu
- Division of Hospital Medicine, Department of Internal Medicine, Taipei City Hospital Zhongxing Branch, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Charles Liao
- Division of Hospital Medicine, Department of General Medicine, Stanford University, School of Medicine, Stanford, CA, USA
| | - Chia-Hao Hsu
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City, 80708, Taiwan.
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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31
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Kanschik D, Bruno RR, Wolff G, Kelm M, Jung C. Virtual and augmented reality in intensive care medicine: a systematic review. Ann Intensive Care 2023; 13:81. [PMID: 37695464 PMCID: PMC10495307 DOI: 10.1186/s13613-023-01176-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Virtual reality (VR) and augmented reality (AR) are rapidly developing technologies that offer a wide range of applications and enable users to experience digitally rendered content in both physical and virtual space. Although the number of studies about the different use of VR and AR increases year by year, a systematic overview of the applications of these innovative technologies in intensive care medicine is lacking. The aim of this systematic review was to provide a detailed summary of how VR and AR are currently being used in various areas of intensive care medicine. METHODS We systematically searched PubMed until 1st March 2023 to identify the currently existing evidence for different applications of VR and AR for both health care providers in the intensive care unit and children or adults, who were in an intensive care unit because of a critical illness. RESULTS After screening the literature, a total of 59 studies were included. Of note, a substantial number of publications consists of case reports, study plans or are lacking a control group. Furthermore, study designs are seldom comparable. However, there have been a variety of use cases for VR and AR that researchers have explored. They can help intensive care unit (ICU) personnel train, plan, and perform difficult procedures such as cardiopulmonary resuscitation, vascular punctures, endotracheal intubation or percutaneous dilatational tracheostomy. Patients might benefit from VR during invasive interventions and ICU stay by alleviating stress or pain. Furthermore, it enables contact with relatives and can also assist patients in their rehabilitation programs. CONCLUSION Both, VR and AR, offer multiple possibilities to improve current care, both from the perspective of the healthcare professional and the patient. It can be assumed that VR and AR will develop further and their application in health care will increase.
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Affiliation(s)
- Dominika Kanschik
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Raphael Romano Bruno
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Georg Wolff
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Duesseldorf, Germany
- Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Duesseldorf, Duesseldorf, Germany
| | - Christian Jung
- Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Duesseldorf, Germany.
- Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Duesseldorf, Duesseldorf, Germany.
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32
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Faria AL, Latorre J, Silva Cameirão M, Bermúdez i Badia S, Llorens R. Ecologically valid virtual reality-based technologies for assessment and rehabilitation of acquired brain injury: a systematic review. Front Psychol 2023; 14:1233346. [PMID: 37711328 PMCID: PMC10497882 DOI: 10.3389/fpsyg.2023.1233346] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/03/2023] [Indexed: 09/16/2023] Open
Abstract
Purpose A systematic review was conducted to examine the state of the literature regarding using ecologically valid virtual environments and related technologies to assess and rehabilitate people with Acquired Brain Injury (ABI). Materials and methods A literature search was performed following the PRISMA guidelines using PubMed, Web of Science, ACM and IEEE databases. The focus was on assessment and intervention studies using ecologically valid virtual environments (VE). All studies were included if they involved individuals with ABI and simulated environments of the real world or Activities of Daily Living (ADL). Results Seventy out of 363 studies were included in this review and grouped and analyzed according to the nature of its simulation, prefacing a total of 12 kitchens, 11 supermarkets, 10 shopping malls, 16 streets, 11 cities, and 10 other everyday life scenarios. These VE were mostly presented on computer screens, HMD's and laptops and patients interacted with them primarily via mouse, keyboard, and joystick. Twenty-five out of 70 studies had a non-experimental design. Conclusion Evidence about the clinical impact of ecologically valid VE is still modest, and further research with more extensive samples is needed. It is important to standardize neuropsychological and motor outcome measures to strengthen conclusions between studies. Systematic review registration identifier CRD42022301560, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=301560.
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Affiliation(s)
- Ana Lúcia Faria
- Faculdade de Artes e Humanidades, Universidade da Madeira, Funchal, Portugal
- NOVA Laboratory for Computer Science and Informatics, Lisbon, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
| | - Jorge Latorre
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
| | - Mónica Silva Cameirão
- NOVA Laboratory for Computer Science and Informatics, Lisbon, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Sergi Bermúdez i Badia
- NOVA Laboratory for Computer Science and Informatics, Lisbon, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
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33
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Oh N, Parrish N, Lee IW, Temple S, Perkins O, Kokkinakis M. Using Virtual Reality to Reduce Anxiety and Improve Hospital Experience in Paediatric Orthopaedic Patients and Their Parents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1409. [PMID: 37628408 PMCID: PMC10453231 DOI: 10.3390/children10081409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
The hospital environment can be a stressful environment for paediatric patients and their parents, which is often characterised by heightened levels of pain and anxiety. To address these challenges, many innovative intervention methods has been explored. For example, immersive virtual reality (VR) headsets as a distraction method has become an increasingly popular intervention in recent years. This study aimed to evaluate the effectiveness of VR using 'Rescape DR.VR Junior' in reducing pain, anxiety, and enhancing the overall hospital experience for paediatric orthopaedic patients and their parents. A total of 64 patients aged 4-18 years were included in this study, which utilised a control group (interacting with a play specialist) and a VR intervention group (including pre-operative patients and fracture clinic patients). Anxiety and pain levels were measured using a 10-point Likert scale before and after the intervention, and validated questionnaires were used to assess parental anxiety and overall hospital experience. The results indicated that VR intervention significantly reduced patient and parental anxiety both before surgery and in the fracture clinic setting (p < 0.5). However, no significant reduction in pain scores was observed in either environments. Comparatively, VR intervention was found to be comparable to traditional play methods in terms of reducing anxiety in the pre-operative environment. All patients and parents agreed that the use of VR distraction methods significantly improved their hospital experience. In conclusion, VR is an effective method for reducing child and parental anxiety and enhancing the hospital experience and can be used alone or in conjunction with a play specialist.
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Affiliation(s)
- Natasha Oh
- Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK; (N.P.); (I.W.L.); (M.K.)
| | - Nina Parrish
- Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK; (N.P.); (I.W.L.); (M.K.)
| | - In Woo Lee
- Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK; (N.P.); (I.W.L.); (M.K.)
| | - Sasha Temple
- Paediatric Orthopaedic Department, Evelina London Children’s Hospital, London SE1 7EH, UK; (S.T.); (O.P.)
| | - Oliver Perkins
- Paediatric Orthopaedic Department, Evelina London Children’s Hospital, London SE1 7EH, UK; (S.T.); (O.P.)
| | - Michail Kokkinakis
- Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK; (N.P.); (I.W.L.); (M.K.)
- Paediatric Orthopaedic Department, Evelina London Children’s Hospital, London SE1 7EH, UK; (S.T.); (O.P.)
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34
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Viderman D, Tapinova K, Dossov M, Seitenov S, Abdildin YG. Virtual reality for pain management: an umbrella review. Front Med (Lausanne) 2023; 10:1203670. [PMID: 37521355 PMCID: PMC10382225 DOI: 10.3389/fmed.2023.1203670] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/15/2023] [Indexed: 08/01/2023] Open
Abstract
Background and objective Virtual reality is a promising pain control strategy for various pain conditions. This umbrella review of systematic reviews and meta-analyses aims to evaluate the analgesic effects of virtual reality. Methods We searched for the relevant reviews in Scopus, PubMed and Cochrane library. Our primary outcome was pain, with secondary outcomes including disability, general health status, patient satisfaction, depression, balance, fear of movement, and adverse events. The quality of included articles was evaluated using the AMSTAR-2 tool. Results 21 systematic reviews and meta-analyses with 274 studies and 17,680 patients were included in this review. All the reviews concluded benefits of virtual reality in managing pain conditions, including chronic and pain. Discussion and conclusions This umbrella review demonstrates successful application of virtual reality in pain control, including perioperative, periprocedural, and chronic pain settings. Virtual reality can be used as an alternative therapy for pain management in children and adults.
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Affiliation(s)
- Dmitriy Viderman
- School of Medicine, Nazarbayev University, Astana, Kazakhstan
- Department of Anesthesiology and Intensive Care, National Research Oncology Center, Astana, Kazakhstan
| | - Karina Tapinova
- School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Mukhit Dossov
- Department of Anesthesiology and Critical Care, Presidential Hospital, Astana, Kazakhstan
| | - Serik Seitenov
- Department of Anesthesiology and Critical Care, Presidential Hospital, Astana, Kazakhstan
| | - Yerkin G. Abdildin
- School of Engineering and Digital Sciences, Nazarbayev University, Astana, Kazakhstan
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Maloca PM, Zarranz-Ventura J, Valmaggia P, Faludi B, Zelechowski M, Tufail A, Zentai NZ, Scholl HPN, Cattin PC. Validation of collaborative cyberspace virtual reality oculometry enhanced with near real-time spatial audio. Sci Rep 2023; 13:10076. [PMID: 37344554 DOI: 10.1038/s41598-023-37267-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/19/2023] [Indexed: 06/23/2023] Open
Abstract
Currently, most medical image data, such as optical coherence tomography (OCT) images, are displayed in two dimensions on a computer screen. Advances in computer information technology have contributed to the growing storage of these data in electronic form. However, the data are usually processed only locally on site. To overcome such hurdles, a cyberspace virtual reality (csVR) application was validated, in which interactive OCT data were presented simultaneously to geographically distant sites (Lucerne, London, and Barcelona) where three graders independently measured the ocular csVR OCT diameters. A total of 109 objects were measured, each three times, resulting in a total of 327 csVR measurements. A minor mean absolute difference of 5.3 µm was found among the 3 measurements of an object (standard deviation 4.2 µm, coefficient of variation 0.3% with respect to the mean object size). Despite the 5 h of online work, csVR was well tolerated and safe. Digital high-resolution OCT data can be remotely and collaboratively processed in csVR. With csVR, measurements and actions enhanced with spatial audio communication can be made consistently in near real time, even if the users are situated geographically far apart. The proposed visuo-auditory framework has the potential to further boost the convenience of digital medicine toward csVR precision and collaborative medicine.
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Affiliation(s)
- Peter M Maloca
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031, Basel, Switzerland.
- Department of Ophthalmology, University Hospital Basel, 4031, Basel, Switzerland.
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK.
| | | | - Philippe Valmaggia
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, 4031, Basel, Switzerland
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | - Balázs Faludi
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
| | - Marek Zelechowski
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
| | - Adnan Tufail
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | - Norbert Z Zentai
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
| | - Hendrik P N Scholl
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031, Basel, Switzerland
- Department of Ophthalmology, University Hospital Basel, 4031, Basel, Switzerland
| | - Philippe C Cattin
- Centre for Medical Image Analysis & Navigation, University of Basel, 4123, Allschwil-Basel, Switzerland
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Gad R, Wilson M. Can we safely manage pain using virtual reality (VR)? Pain Manag Nurs 2023; 24:243-245. [PMID: 37230732 DOI: 10.1016/j.pmn.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Rasha Gad
- School of Nursing Mansoura University, Mansoura, Egypt.
| | - Marian Wilson
- College of Nursing Washington State University, Spokane, WA USA.
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Affiliation(s)
- Rogier Barendse
- Digital Cardiology, Department of Clinical Epidemiology and Innovation, Thoraxcenter, Department of Cardiology, Erasmus MC, Room Na-312, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Nico Bruining
- Corresponding author. Tel: +31651733542, E-mail address:
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