Bright light and oxygen therapies decrease delirium risk in critically ill surgical patients by targeting sleep and...

Area of Science:

• Critical Care Medicine
• Neuroscience
• Sleep Medicine

Background:

• Delirium is a common complication in surgical intensive care units (SICUs).
• Identifying effective interventions and risk factors for post-operative delirium is crucial for patient outcomes.

Purpose of the Study:

• To investigate the efficacy of bright light therapy (BLT) in preventing delirium in SICU patients.
• To identify risk and protective factors associated with delirium development post-surgery.

Main Methods:

• A single-blind, randomized controlled study involving 62 post-operative patients.
• Intervention group received standard care plus BLT for three days; delirium assessed using CAM-ICU based on DSM-5 criteria.
• Risk factors measured included APACHE II score, Insomnia Severity Index (ISI), hematocrit, and bicarbonate levels.

Main Results:

• Thirteen patients developed delirium within three days post-surgery.
• BLT demonstrated a significant preventive effect on delirium, independent of other factors.
• Higher APACHE-II and ISI scores, and lower hematocrit/bicarbonate levels were associated with increased delirium risk.
• BLT plus nasal cannula oxygen significantly reduced delirium likelihood.
• BLT lowered ISI scores; oxygen enhanced bicarbonate levels.

Conclusions:

• BLT is an effective strategy for preventing delirium in SICU patients.
• Supplementary oxygen therapy may also play a protective role.
• BLT and oxygen may mitigate delirium by addressing sleep-wake disturbances and bicarbonate buffer system deficits.