Virtual reality for delirium prevention in mechanically ventilated ICU patients: a narrative review

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. Methods 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. Results 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.