Open ICU visiting was linked to less delirium

Design

Systematic review and meta-analysis of randomised trials

Population

13 trials, 3861 adult ICU patients

Primary outcome

Delirium occurrence

Effect

RR 0.48 (95% CI 0.29-0.81); no change in infection or mortality

A meta-analysis in Critical Care Medicine pooled 13 randomised trials (3861 adult ICU patients) comparing open or flexible family visiting with restricted visiting. Published on 15 October 2026.

Open visiting was associated with about half the rate of delirium (RR 0.48, 95% CI 0.29 to 0.81) and slightly shorter mechanical ventilation (by about a third of a day). Hospital-acquired infections, ICU length of stay and mortality did not differ.

Family presence helps orientation, sleep and reassurance, all of which matter for delirium. The worry that visitors increase infection was not borne out.

Certainty was low and heterogeneity substantial, and visiting policies differed widely across trials. Still, the balance of benefit against harm favours letting families in.

• Consider flexible visiting hours for families of ICU patients
• Involve family in reorientation, glasses and hearing aids, and normal routines
• Keep hand hygiene and infection control standards for visitors
• Screen for delirium every shift whatever the visiting policy

Why it matters

Restricted visiting is a policy choice that may be adding to delirium.

Don't overread it

Certainty was low and visiting policies varied widely between trials.

The statistics, in plain English

An RR of 0.48 means about half the risk, and the confidence interval stays below 1, but low certainty means further trials could change the size of the effect.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.