Real-time reorientation and cognitive load adjustment allow for broad application of virtual reality in a pediatric hospital. Journal of clinical and translational research Caruso, T. J., Fonseca, A., Barreau, A., Khoury, M., Menendez, M., Wang, E., Lawrence, K., Jackson, C., Rodriguez, S. 1800; 7 (6): 750-753


Background: With a new generation of affordable portable virtual reality (VR), clinicians are discovering more utility for VR, while also identifying opportunities for improvement, such as the inability to reorient the horizon line during repositioning or transport, or modulate cognitive load in real time.Aim: At our institution, this lack of functionality prohibited or decreased VR usage in some clinical scenarios such as dressing changes with dynamic positioning. The purpose of this brief report is to describe the development and use of a VR application that is optimized for the healthcare setting and report historical effects of patients who utilized VR as supplement to Child Life procedures. Eligible affects per chart review included Happy, Relaxed, Anxious, Distressed, Unable to Assess.Materials and Methods: Given the need for real-time reorientation and cognitive load modulation, we created the Space Pups VR application. The experience was launched as part of the Stanford Chariot Program in the summer of 2017, and its usage was tracked through the electronic medical record and a VR application dashboard. Chart review was queried from 3 January 2018 to 9 August 2021 for pediatric patients who used VR with real-time reorientation and cognitive load modulation as a supplement to their Child Life interventions.Results: The Space Pups experience has been successfully used in a variety of settings, including perioperative care, vascular access, wound care, and ENT clinic, a total of 1696 times. Patients ranged from 6 years to 18-year old, with no reports of side effects. Significant results (P<0.001) were observed pre- and post-VR use for affect improvements in Happy, Relaxed, and Anxious, but not for Distressed.Conclusions: The ability to reorient VR experiences in real time has increased functionality where other applications have failed.Relevance for Patients: While more studies are needed to quantify the anxiolytic and pain-reducing effect of Space Pups, our report demonstrates the feasibility of this VR experience as a non-pharmacological modality to safely increase patient cooperation in a wide variety of clinical settings.

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