Virtual Reality for Delirium Prevention in Mechanically Ventilated ICU Patients: A Narrative Review

Jiaxin Li^1,2,3,4MengYao Su^1,4Yuhao ZHAO^1,2,4Yuxin ZHU^1,2,4Yuna Hu^1,5,6Huijie ZHAO^2,4,7,8Liming LI^10,5,7,9*

• ¹Henan University, Kaifeng, China
• ²College of Nursing and Health, Henan University, Kaifeng, China, Kaifeng, China
• ³Henan University School of Nursing and Health Sciences, Kaifeng, China
• ⁴College of Nursing and Health, Henan University, Kaifeng, China
• ⁵Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, Zhengzhou, China
• ⁶Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China
• ⁷College of Nursing and Health, Zhengzhou University, Zhengzhou, China, Zhengzhou, China
• ⁸College of Nursing and Health, Henan University, Zhengzhou, China
• ⁹Nursing Department of Henan Provincial People's Hospital, Zhengzhou, China, Zhengzhou, China
• ¹⁰Henan Provincial People's Hospital, Zhengzhou, China

Objective: To explore the advantages, applications and shortcomings of virtual reality technology in the prevention of delirium in ICU patients with mechanical ventilation, and to provide references for clinical practice and research in this field. Method: This study adopted the narrative review method and systematically retrieved nine databases and related websites including PubMed, Web of Science, Scopus, Embase, Cochrane Library, China Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang, and VIP database. It aims to collect relevant Chinese and English literature published before April 30, 2025. This study reviews the application, effect and evaluation of virtual reality technology in the prevention of delirium in ICU patients with mechanical ventilation. Result: Virtual reality technology can effectively alleviate patients' negative emotions, enhance the interest and compliance of early activities, and have a positive impact on cognitive functions such as working memory by providing immersive experiences, thereby reducing the risk of delirium from multiple dimensions. Existing evidence indicates that this technology has basic safety and feasibility in such critically ill patients. However, current research generally has limitations such as small sample size, lack of support from high-quality randomized controlled trials, relatively single virtual reality content, insufficient personalization, and insufficient validation of the reliability and validity of related usability evaluation tools in the ICU population. Conclusion: Virtual reality technology has shown significant potential in preventing delirium in ICU patients with mechanical ventilation. Future research should focus on constructing systematic and individualized virtual reality intervention programs, developing and verifying assessment tools suitable for local ICU patients, and further clarifying its long-term efficacy, optimal implementation model and cost-effectiveness through multi-center large-sample studies, so as to promote the standardized application and clinical transformation of this technology.