eISSN 2097-6046
ISSN 2096-7446
CN 10-1655/R
Responsible Institution:China Association for Science and Technology
Sponsor:Chinese Nursing Association
Evidence Synthesis Research

Effects of sensory stimulation on consciousness levels in ICU patients:a network meta-analysis

  • WAN Chengshuang ,
  • HAN Chunyan ,
  • XU Huihui ,
  • WANG Shujuan ,
  • WEI Lanling ,
  • CHEN Fujuan
Expand

Received date: 2024-10-20

  Online published: 2025-09-25

Abstract

Objective To evaluate the effectiveness of sensory stimulation on ICU patients’ consciousness levels,considering different implementers,content,frequency,and duration. Methods A systematic search was conducted in PubMed,Cochrane Library,Web of Science,Embase,CNKI,Wanfang,and VIP databases. The inclusion criteria included randomized controlled trials involving ICU patients,the intervention methods for the experimental group were sensory stimulation with different protocols,while the intervention methods for the control group were routine nursing or other programs. The primary outcome was post-intervention Glasgow Coma Scale scores. Two researchers independently screened studies,extracted data,and assessed bias. A network meta-analysis using R 4.3.2 Gemtc package and the optimal ranking probability of intervention programs was calculated by accumulating the area under the ranking curve. Results Fourteen studies were included. Sensory stimulation with direct family involvement was most effective,followed by indirect family and nurse-led interventions. Multi-sensory stimulation outperformed combined or single-sensory approaches. Twice-daily interventions were most effective,followed by three times a day and once a day. 10 days interventions were most effective,followed by>30 days,7 days,30 days and <7 days. Conclusion Based on the limited evidence,sensory stimulation improves ICU patients’ consciousness,with family involvement and multi-sensory approaches yielding the best outcomes. The intervention period should be at least 7 days to produce good results,and twice daily sensory stimulation is the optimal frequency.

Cite this article

WAN Chengshuang , HAN Chunyan , XU Huihui , WANG Shujuan , WEI Lanling , CHEN Fujuan . Effects of sensory stimulation on consciousness levels in ICU patients:a network meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025 , 6(10) : 1245 -1252 . DOI: 10.3761/j.issn.2096-7446.2025.10.018

References

[1] Zou JJ, Chen Q, Wang JJ, et al. Effects of virtual reality for psychological health of ICU patients:a study protocol for systematic review and meta-analysis[J]. BMJ Open, 2023, 13(7):e073660.
[2] Naef AC, Gerber SM, Single M, et al. Effects of immersive vir-tual reality on sensory overload in a random sample of criti-cally ill patients[J]. Front Med, 2023,10:1268659.
[3] Martin YB, Negredo P, Avenda?o C. Experience-dependent plas-ticity in early stations of sensory processing in mature brains:effects of environmental enrichment on dendrite measures in trigeminal nuclei[J]. Brain Struct Funct, 2022, 227(3):865-879.
[4] Liang SR, Pak Chun Chau J, Hoi Shan Lo S, et al. The effects of a sensory stimulation intervention on psychosocial and clinical outcomes of critically ill patients and their families:a randomised controlled trial[J]. Intensive Crit Care Nurs, 2023, 75:103369.
[5] Zuo JJ, Tao YL, Liu M, et al. The effect of family-centered sensory and affective stimulation on comatose patients with traumatic brain injury:a systematic review and meta-analysis[J]. Int J Nurs Stud, 2021,115:103846.
[6] Sterne JAC, Savovi? J, Page MJ, et al. RoB 2:a revised tool for assessing risk of bias in randomised trials[J]. BMJ, 2019,366:l4898.
[7] Yan XY, Xu M, Su FJ. Surgical managements for rhegmato-genous retinal detachment:a network meta-analysis of rando-mized controlled trial[J]. PLoS One, 2024, 19(11):e0310859.
[8] Izcovich A, Chu DK, Mustafa RA, et al. A guide and pragmatic considerations for applying GRADE to network meta-analysis[J]. BMJ, 2023,381:e074495.
[9] Dias S, Welton NJ, Sutton AJ, et al. Evidence synthesis for de-cision making 4:inconsistency in networks of evidence based on randomized controlled trials[J]. Med Decis Making, 2013, 33(5):641-656.
[10] Abbasi M, Mohammadi E, Sheaykh Rezayi A. Effect of a regular family visiting program as an affective,auditory,and tactile stimulation on the consciousness level of comatose patients with a head injury[J]. Jpn J Nurs Sci, 2009, 6(1):21-26.
[11] Hoseinzadeh E, Shan GRM, Vakili MA, et al. Effect of audi-tory stimulation on consciousness in coma patients with head injury:a randomized clinical trial[J]. J Nurs Midwifery Sci, 2017, 4(3):82-88.
[12] ?evik K, Namik E. Effect of auditory stimulation on the level of consciousness in comatose patients admitted to the inten-sive care unit:a randomized controlled trial[J]. J Neurosci Nurs, 2018, 50(6):375-380.
[13] Tavangar H, Shahriary-Kalantary M, Salimi T, et al. Effect of family members’ voice on level of consciousness of comatose patients admitted to the intensive care unit:a single-blind ran-domized controlled trial[J]. Adv Biomed Res, 2015,4:106.
[14] Khojeh A, Sajjadi M, Ajam H. The effect of the organized auditory stimulation with a familiar voice on pain intensity and physiological indices of comatose patients admitted to the intensive care unit[J]. J Res Med Dent Sci, 2018,6:69-77.
[15] Varghese R, Sulochana B, D’Souza PJJ. Effectiveness of voice stimulus on the level of consciousness,physiological parame-ters and behavioural responses in comatose patients:a feasibility study[J]. Clin Epidemiol Glob Health, 2021,9:150-156.
[16] Salmani F, Mohammadi E, Rezvani M, et al. The effects of family-centered affective stimulation on brain-injured comatose patients’ level of consciousness:a randomized controlled trial[J]. Int J Nurs Stud, 2017,74:44-52.
[17] Ahmed FR, Attia AK, Mansour H, et al. Outcomes of family-centred auditory and tactile stimulation implementation on traumatic brain injured patients[J]. Nurs Open, 2023, 10(3):1601-1610.
[18] Moattari M, Alizadeh Shirazi F, Sharifi N, et al. Effects of a sensory stimulation by nurses and families on level of cog-nitive function,and basic cognitive sensory recovery of coma-tose patients with severe traumatic brain injury:a randomized control trial[J]. Trauma Mon, 2016, 21(4):e23531.
[19] Rahimi F, Salehi K, Seidi J. The effect of pleasant audio stimulation on the level of consciousness of comatose pa-tient:a randomized clinical trial[J]. Acta Med Mediterr, 2019, 35(2):985-997.
[20] 俞士隔, 刘勤, 张倩. 多感觉联合刺激护理对重症颅脑损伤昏迷患者苏醒、神经功能及并发症的影响[J]. 临床与病理杂志, 2023, 43(7):1431-1438.
  Yu SG, Liu Q, Zhang Q. Effect of multi-sensory stimulation nursing on recovery,neurological function,and complications of coma patients with severe traumatic brain injury[J]. J Clin Pathol Res, 2023, 43(7):1431-1438.
[21] 谢莉莉, 陈翰, 江雪冰, 等. 感觉刺激对ICU重症颅脑损伤昏迷患者的促醒作用分析[J]. 中外医疗, 2019, 38(30):157-159.
  Xie LL, Chen H, Jiang XB, et al. Analysis of the stimulating effect of sensory stimulation on patients with severe craniocerebral injury and coma in ICU[J]. China Foreign Med Treat, 2019, 38(30):157-159.
[22] 吴健琴, 王凌峰, 刘洪君, 等. 呼唤护理模式在重型颅脑损伤昏迷患者中的应用[J]. 护士进修杂志, 2008, 23(16):1476-1477.
  Wu JQ, Wang LF, Liu HJ, et al. Study on effect of calling nursing mode to improve of severe traumatic brain injury patient with coma[J]. J Nurses Train, 2008, 23(16):1476-1477.
[23] 堵慈峰. 家属参与下的多重感觉刺激配合高压氧对颅脑损伤昏迷患者的促醒效果[J]. 中国老年保健医学, 2021, 19(2):154-157.
  Du CF. Effect of multiple sensory stimulation with family participation combined with hyperbaric oxygen on comatose patients with craniocerebral injury[J]. Chin J Geriatr Care, 2021, 19(2):154-157.
[24] 唐冬梅, 张红, 曾莉. ICU护士对家庭参与式感觉刺激护理的认知与实践调查[J]. 中华急危重症护理杂志, 2024, 5(11):1028-1034.
  Tang DM, Zhang H, Zeng L. Investigation on the p practice and influencinggfactorsof ICU nurses on familyyparticipatory sensor stimulation behaviors in patients with consciousness disorder[J]. Chin J Emerg Crit Care Nurs, 2024, 5(11):1028-1034.
[25] 郭绮莹, 董燕燕, 凌冬兰, 等. 以患者-家庭为中心照护模式在成人ICU应用的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(10):950-956.
  Guo QY, Dong YY, Ling DL, et al. Summary of the best evi-dence of patient-and family-centered care in adult ICUs[J]. Chin J Emerg Crit Care Nurs, 2024, 5(10):950-956.
[26] Kor PPK, Parial LL, Yu CTK, et al. Effects of a family care-giver-delivered MultiSensory cognitive stimulation intervention for older people with dementia during coronavirus 2019:a ran-domized controlled trial[J]. Gerontologist, 2024, 64(2):gnad054.
[27] Tonti E, Budini M, Vingolo EM. Visuo-acoustic stimulation’s role in synaptic plasticity:a review of the literature[J]. Int J Mol Sci, 2021, 22(19):10783.
[28] Olcese U, Oude Lohuis MN, Pennartz CMA. Sensory processing across conscious and nonconscious brain states:from single neurons to distributed networks for inferential representation[J]. Front Syst Neurosci, 2018,12:49.
[29] Hogan MK, Hamilton GF, Horner PJ. Neural stimulation and molecular mechanisms of plasticity and regeneration:a review[J]. Front Cell Neurosci, 2020,14:271.
[30] Evancho A, Tyler WJ, McGregor K. A review of combined neu-romodulation and physical therapy interventions for enhanced neurorehabilitation[J]. Front Hum Neurosci, 2023,17:1151218.
[31] Clayton E, Kinley-Cooper SK, Weber RA, et al. Brain stimula-tion:Neuromodulation as a potential treatment for motor re-covery following traumatic brain injury[J]. Brain Res, 2016, 1640(Pt A):130-138.
Outlines

/