The delirium diagnosed with shockingly high frequency in critically ill patients seems to be iatrogenic all too often. Without an effective way to treat it, we are left with prevention as the primary strategy with all other intervention reactive and unproven. It is in this spirit of prevention that sleep disruption is being investigated as a potentially modifiable risk factor for the development of ICU delirium.

Our project addresses one of the pressing issues of ICU medicine – properly informing post-ICU patients and their families about the increasing body of research documenting the deficits faced by a significant percentage of survivors of intensive care, specifically neuro-cognitive dysfunction, depression, anxiety and post-traumatic stress disorder, ICU-acquired muscle weakness, and chronic pain. These documented deficits are classified as one of two syndromes, post intensive care syndrome [“PICS”] and family post intensive care syndrome [PICS-F”].

Delirium, the most common form of acute brain dysfuntion affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long term cognitve impairment, one of the domains in "Post-ICU Syndrome" (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep-wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.