Eye tracking communication in the ICU

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Eye tracking at the ICU-global market

In the US, 5.7 million patients are admitted to the ICU annually. Data and information on ICU practices is very limited and fragmented. Although there is no worldwide available data, in addition to the US data, the annual number of ICU patients for the 7 European countries from comprehensive research is also as follows: Germany 2 million, Ireland 30K, UK 200K, Netherlands 70K, Denmark 33K, France 200K, Spain 240K.

Out of 5.7 million patients who are admitted to the ICU annually in the US, 20-30% require mechanical ventilation. Research conducted on the subject suggests that the people most likely to be candidates for using an eye-tracker device will be on the ventilator. Since the use of eye trackers requires sessions of training, ideal patients for eye trackers are those who are additionally expected to be at least mentally intact, able to be trained and who can communicate by no other means.

Critical case statistics in the US found that more than 5.7 million patients are admitted annually to ICU. The top 5 primary diagnoses for admission are: "respiratory system diagnosis with ventilator support, acute myocardial infarction, intracranial hemorrhage or cerebral infarction, percutaneous cardiovascular procedure with drug-eluting stent, and septicemia or severe sepsis without mechanical ventilation". It is also discovered that 20-30% of U.S. ICU admissions require mechanical ventilation. Childhood-onset chronic conditions have been reported in 53% of patients admitted to the pediatric ICU.


Research specifically done on this subject offered eye-trackers to 12 patients on ventilators in ICU at the Johns Hopkins Hospital mentions that patients who were trained with eye trackers were less confused, happier and more confident in their ability to communicate. But the patients were still dependent on able-bodied people to position the eye-tracker, and patients found it hard to maintain a comfortable position or concentration to be able to use the device effectively. Unfortunately, the study size was too small to determine if the eye tracking devices helped or improved communication with the patients, but the trial showed the technology could have promise in patients who meet the criteria.


Another pilot study on the subject where patients in the medical, surgical and neuroscience ICU were enrolled, suggests that eye-tracking devices might improve communication and psycho social status among patients in the ICU. The conclusion of this study, though, was that more in-depth exploration of the possibility of eye tracker use in the ICU needs to be done.


A more recent study hypothesized that ETDs would be useful in mechanically ventilated surgery/trauma intensive care unit (SICU) patients and, as a result, mentions that finding ideal patients is difficult. The study states that of the 95 patients selected for the study, only 5 patients were able to meet the proper criteria and participated in the study. The 90 other patients were not used because of the following reasons:

1. They were on the ventilator for less than 48hrs
2. Their RASS score was less than -1 or greater than 1+
3. They had a visual impairment
4. The presence of cognitive impairment
5. TBI with GCS was less than 15

RASS stands for Richmond Agitation-Sedation Scale:

4+ Combative
3+ Very agitated
2+ Agitated
1+ Restless
0 Alert and calm
-1 Drowsy
-2 Light sedation
-3 Moderate sedation
-4 Deep sedation
-5 Unarousable sedation

Although previous studies theorized that a substantial proportion of mechanically ventilated ICU patients can use ETD, they found a limited proportion of eligible patients due to strict criteria.


To sum up, there is not enough and clear information available to determine a market size for people who use eye-tracking devices in the ICU environment. Very few studies that have been conducted on the subject have been inconclusive and limited in their results suggesting further studies needed. Because of the limited information available on who actually qualifies for the ability to use an eye tracking device while in the ICU, the answer to the question is inconclusive.