Application of eye tracking techniques in ICU patients with aphasia：a scoping review

doi:10.3761/j.issn.0254-1769.2025.06.019

Abstract

Abstract:

Objective This review aims to investigate the application of eye tracking（ET） in patients with speech impairment in the ICU. The review summarizes the current status and prospects of ET technology applications. Methods Following the scoping reviews framework，a systematic search was conducted across Web of Science，PubMed，Cochrane Library，Embase，CINAHL，CNKI，Wanfang Data，Chinese Medical Database，and Chinese biomedical database. The search covered publications from the inception of each database to October 29th，2024. The included studies were comprehensively analyzed. Results A total of 12 pieces of the literature were included，including 4 prospective cohort studies，4 experimental studies，3 prospective observational studies，and 1 randomized controlled trial. The application population of ET in the ICU mainly includes patients on mechanical ventilation，those at high risk of delirium，patients with spinal cord injury，etc. The types of integrated ET system equipment are mainly head-mounted and fixed；the types of ET involve gaze，blinking，etc.；the functions include standardized scale assessment，free interaction，and eye-movement model recognition. The main outcome indicators of the research are feasibility，physical symptoms and social-psychological status. Conclusion ET is applicable to a specific group of ICU patients with aphasia，and has shown good feasibility and effectiveness in the expression of patients’ basic needs，self-assessment of symptoms and improvement of psychosocial status.

Key words: Eye Tracking, Intensive Care Unit, Apraxia of Speech, Scoping Review, Nursing Care

摘要：

目的对眼动追踪在ICU言语不能患者中的应用进行范围综述，为开展相关研究提供参考。方法基于范围综述框架，系统检索Web of Science、PubMed、Cochrane Library、Embase、CINAHL、中国知网、万方数据库、中华医学期刊全文数据库、中国生物医学文献数据库，检索时限为建库至2024年10月29日。由2名研究者对纳入的文献进行综合分析。结果共纳入12篇文献，包括4篇前瞻性队列研究、4篇类实验研究、3篇前瞻性观察性研究、1篇随机对照试验。眼动追踪在ICU中的应用人群主要包括机械通气、谵妄高风险、脊髓损伤患者等。眼动追踪系统集成设备类型主要包括头戴式、固定式；眼动追踪指征涉及注视、眨眼等；功能包括范式化评估、自由沟通以及眼动模型识别；主要结局指标为研究的可行性、躯体症状及社会心理状态。结论眼动追踪适用于特定的ICU言语不能患者，并在患者的基本需求表达、症状自我评估及社会心理状态改善方面有一定的可行性和有效性。

关键词: 眼动追踪, 重症监护病房, 言语失用, 范围综述, 护理

HUANG Zhenzhen, SUI Weijing, DONG Jing, ZHANG Junru, ZHANG Chuchu, ZHOU Hongting, ZHANG Jiayu, ZHANG Na, ZHUANG Yiyu. Application of eye tracking techniques in ICU patients with aphasia：a scoping review[J]. Chinese Journal of Nursing, 2025, 60(6): 757-763.

黄真真, 隋伟静, 董婧, 张君如, 张楚楚, 周泓廷, 张佳宇, 张娜, 庄一渝. 眼动追踪在ICU言语不能患者中应用的范围综述[J]. 中华护理杂志, 2025, 60(6): 757-763.

Figures/Tables 1

References 26

[1]	Ten Hoorn S, Elbers PW, Girbes AR, et al. Communicating with conscious and mechanically ventilated critically ill patients:a systematic review[J]. Crit Care, 2016, 20(1):333.
[2]	Vincent JL, Shehabi Y, Walsh TS, et al. Comfort and patient-centred care without excessive sedation:the eCASH concept[J]. Intensive Care Med, 2016, 42(6):962-971.
[3]	Ma JG, Zhu B, Jiang L, et al. Gender- and age-based differen-ces in outcomes of mechanically ventilated ICU patients:a Chinese multicentre retrospective study[J]. BMC Anesthesiol, 2022, 22(1):18. DOI PMID
[4]	Ull C, Hamsen U, Weckwerth C, et al. Approach to the basic needs in patients on invasive ventilation using eye-tracking devices for non-verbal communication[J]. Artif Organs, 2022, 46(3):439-450.
[5]	杨玲虹, 贾瑞英, 魏慧, 等. 音乐疗法对卒中后失语患者干预效果的Meta分析[J]. 中华护理杂志, 2024, 59(15):1908-1915. DOI
	Yang LH, Jia RY, Wei H, et al. The effects of music therapy on patients with post-stroke aphasia:a Meta-analysis[J]. Chin J Nurs, 2024, 59(15):1908-1915.
[6]	陈李英, 陈琼妮, 肖艳超. 成人ICU患者身体约束的不良后果及干预措施研究现状[J]. 中国护理管理, 2020, 20(11):1737-1741.
	Chen LY, Chen QN, Xiao YC. Adverse consequences and inter ventions of physical restraint in adult intensive care units[J]. Chin Nurs Manag, 2020, 20(11):1737-1741.
[7]	魏梦瑶, 李梦文, 李秋萍, 等. 三四级手术老年患者获得性衰弱风险预测模型的构建及验证[J]. 中华护理杂志, 2023, 58(23):2843-2851. DOI
	Wei MY, Li MW, Li QP, et al. Construction and validation of ICU acquired weakness risk prediction model in elderly pa-tients undergoing tertiary and quaternary surgery[J]. Chin J Nurs, 2023, 58(23):2843-2851.
[8]	Waydhas C, Ull C, Cruciger O, et al. Behavioral Pain Scale may not be reliable in awake non-verbal intensive care patients:a case control study[J]. BMC Anesthesiol, 2024, 24(1):84.
[9]	Geense WW, Zegers M, Peters MAA, et al. New physical,men-tal,and cognitive problems 1 year after ICU admission:a pro-spective multicenter study[J]. Am J Respir Crit Care Med, 2021, 203(12):1512-1521.
[10]	Freeman-Sanderson A, Rose L. Outcomes after critical illness[J]. N Engl J Med, 2023, 389(4):382.
[11]	尤佳璐, 惠延年, 张乐. 眼球运动及眼动追踪技术的临床应用进展[J]. 国际眼科杂志, 2023, 23(1):90-95.
	You JL, Hui YN, Zhang L. Eye movements and pro-gression of clinical applications of eye tracking technology[J]. Int Eye Sci, 2023, 23(1):90-95.
[12]	郑成艳, 王哲, 严璘璘. 眼动追踪技术的研究述评[J]. 分析仪器, 2021(2):141-144.
	Zheng CY, Wang Z, Yan LL. Review of eye-movement tracking technique[J]. Anal Instrum, 2021(2):141-144.
[13]	Itai Bendavid I, Assi S, Sasson N, et al. The EyeControl-Med device,an alternative tool for communication in ventilated critically ill patients:a pilot study examining communication capabilities and delirium[J]. J Crit Care, 2023, 78:154351.
[14]	王喜益, 叶志弘, 汤磊雯. 范围综述在护理领域的应用进展[J]. 中华护理杂志, 2019, 54(8):1259-1263. DOI
	Wang XY, Ye ZH, Tang LW. An integrative review of scoping review applied in nursing literature[J]. Chin J Nurs, 2019, 54(8):1259-1263.
[15]	Maringelli F, Brienza N, Scorrano F, et al. Gaze-controlled,com-puter-assisted communication in intensive care unit:“speak-ing through the eyes”[J]. Minerva Anestesiol, 2013, 79(2):165-175. PMID
[16]	Garry J, Casey K, Cole TK, et al. A pilot study of eye-tracking devices in intensive care[J]. Surgery, 2016, 159(3):938-944.
[17]	Duffy EI, Garry J, Talbot L, et al. A pilot study assessing the spiritual,emotional,physical/environmental,and physiological needs of mechanically ventilated surgical intensive care unit patients via eye tracking devices,head nodding,and commu-nication boards[J]. Trauma Surg Acute Care Open, 2018, 3(1):e000180.
[18]	Bodet-Contentin L, Messet-Charrière H, Gissot V, et al. Assess-ing oral comprehension with an eye tracking based innovative device in critically ill patients and healthy volunteers:a co-hort study[J]. Crit Care, 2022, 26(1):288.
[19]	Ull C, Hamsen U, Weckwerth C, et al. The use of predefined scales and scores with eye-tracking devices for symptom identification in critically ill nonverbal patients[J]. J Trauma Acute Care Surg, 2022, 92(4):640-647.
[20]	Bodet-Contentin L, Szymkowicz E, Delpierre E, et al. Eye track-ing communication with intubated critically ill patients:a proof-of-concept multicenter pilot study[J]. Minerva Anestesiol, 2022, 88(9):690-697. DOI PMID
[21]	Ull C, Weckwerth C, Schildhauer TA, et al. First experiences of communication with mechanically ventilated patients in the intensive care unit using eye-tracking technology[J]. Disabil Rehabil Assist Technol, 2023, 18(1):44-49.
[22]	Szymkowicz E, Bodet-Contentin L, Marechal Y, et al. Compa-rison of communication interfaces for mechanically ventilated patients in intensive care[J]. Intensive Crit Care Nurs, 2024, 80:103562.
[23]	Al-Hindawi A, Vizcaychipi M, Demiris Y. A dual-camera eye-tracking platform for rapid real-time diagnosis of acute deli-rium:a pilot study[J]. IEEE J Transl Eng Health Med, 2024, 12:488-498.
[24]	王欢, 李圣娟, 李晨, 等. 康复期脑卒中失语症患者疾病体验及需求的Meta整合[J]. 中华护理杂志, 2024, 59(7):873-881. DOI
	Wang H, Li SJ, Li C, et al. The illness experience and demands of patients with poststroke aphasia during rehabilitation:a qualitative meta-synthesis[J]. Chin J Nurs, 2024, 59(7):873-881.
[25]	中华医学会呼吸病学分会,中国医师协会呼吸医师分会危重症医学专家组. 成人呼吸危重症患者镇痛镇静管理及相关问题专家共识[J]. 中华结核和呼吸杂志, 2023, 46(12):1162-1175.
	Respiratory Medicine Branch of the Chinese Medical Asso-ciation,Critical Care Medicine Expert Group of the Respira-tory Medicine Branch of the Chinese Medical Association. Expert consensus on management of pain,agitation and rela-ted issues in adult patients with critical respiratory diseases[J]. Chin J Tuberc Respir Dis, 2023, 46(12):1162-1175.
[26]	汤铂, 陈文劲, 蒋丽丹, 等. 重症后管理专家共识[J]. 中华内科杂志, 2023, 62(5):480-493. PMID
	Tang B, Chen WJ, Jiang LD, et al. Expert consensus on late stage of critical care management[J]. Chin J Intern Med, 2023, 62(5):480-493. DOI PMID