The EyeControl-Med device, an alternative tool for communication in ventilated critically ill patients: A pilot study examining communication capabilities and delirium

I Itai Bendavid; Saja Assi; Noga Sasson; Liran Statlender; Moran Hellerman; Guy Fishman; Pierre Singer; Ilya Kagan

doi:10.1016/j.jcrc.2023.154351

The EyeControl-Med device, an alternative tool for communication in ventilated critically ill patients: A pilot study examining communication capabilities and delirium

J Crit Care. 2023 Dec:78:154351. doi: 10.1016/j.jcrc.2023.154351. Epub 2023 Jun 21.

Authors

I Itai Bendavid¹, Saja Assi², Noga Sasson², Liran Statlender³, Moran Hellerman³, Guy Fishman³, Pierre Singer³, Ilya Kagan³

Affiliations

¹ Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. Electronic address: itbd@walla.com.
² Department of speech, language, swallowing, hearing & communication disorders, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
³ Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.

PMID: 37348187
DOI: 10.1016/j.jcrc.2023.154351

Abstract

Introduction: Communication with ventilated patients in the Intensive care unit (ICU) is challenging. This may lead to anxiety and frustration, potentially contributing to the development of delirium. Various technologies, such as eye-tracking devices, have been employed to facilitate communication with varying grades of success. The EyeControl-Med device is a novel technology that delivers audio content and allows patients to interact by eye movements and could potentially allow for better communication in this setting. The aim of this exploratory concept study was to assess communication capabilities and delirium incidence using the EyeControl-Med device in critically ill patients unable to generate speech.

Material and methods: A single-arm pilot study of patients in a mixed ICU. Patients were approached for consent if they were invasively ventilated and/or tracheotomized, hence unable to generate speech, but had no severe cognitive or sensory impairment that could prevent proper usage. Patients underwent at least 3 sessions with the EyeControl-Med device administered by a speech-language pathologist. Communication and consciousness were assessed using the Loewenstein Communication Scale (LCS) tool during the first and last sessions. Delirium was assessed using a computerized CAM-ICU questionnaire.

Results: 15 patients were included, 40% of whom were diagnosed with COVID-19. All patients completed three to seven usage sessions. The mean LCS score improved by 19.3 points (p < 0.0001), with each of its five components showing significant improvements as well. The mean number of errors on the CAM-ICU questionnaire decreased from 6.5 to 2.5 (p = 0.0006), indicating a lower incidence of delirium. No adverse effects were observed.

Conclusion: The EyeControl-Med device may facilitate communication and reduce the manifestations and duration of delirium in ventilated critically ill patients. Controlled studies are required to establish this effect.

Keywords: Communication; Critically ill; Delirium; Mechanical ventilation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Communication
Critical Illness / psychology
Critical Illness / therapy
Delirium* / diagnosis
Humans
Intensive Care Units
Pilot Projects
Respiration, Artificial / adverse effects