- Design
- Systematic review and meta-analysis of 13 randomised trials
- Population
- 3,861 adult ICU patients
- Primary outcome
- Delirium occurrence
- Effect
- RR 0.48 (95% CI 0.29–0.81); ventilation −0.36 days
A meta-analysis in Critical Care Medicine (15 October) pooled 13 randomised trials (3,861 adults) comparing open or flexible ICU visiting with restricted visiting.
Open visiting was associated with about half the rate of delirium (risk ratio 0.48) and slightly shorter ventilation (about a third of a day). Hospital-acquired infections and ICU mortality did not increase.
The certainty is low and the trials varied widely, but the direction is consistent and the main fear about open visiting — infection — was not borne out. Units that restrict visiting tightly have a reason to revisit those rules.
- Open or flexible visiting was linked to about half the delirium rate
- No increase in infection or mortality was seen
- Involve families in reorientation and comfort
- Review restrictive visiting rules against this evidence
Why it matters
Restricted visiting is often justified by infection risk that these trials did not find.
Don't overread it
Low-certainty evidence with substantial heterogeneity across trials.
The statistics, in plain English
RR 0.48 (95% CI 0.29 to 0.81) is a large effect, but low certainty means further trials could shrink it considerably.
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