The ABCDEF Bundle in Critical Care

Marra, Annachiara; Ely, E. Wesley; Pandharipande, Pratik P.; Patel, Mayur B.

doi:10.1016/j.ccc.2016.12.005

Cited by 493 publications

(453 citation statements)

References 77 publications

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“…Family engagement is important as visitors are largely excluded from isolation wards [78]. Effective communication is necessary to address concerns and manage expectations, or to help determine goals of care in the critically ill. Public relations departments and social workers should be involved to facilitate communication with family members or the public media, to minimise misunderstanding and build trust and confidence in the healthcare system [79].…”

Section: Family Engagementmentioning

confidence: 99%

Preparing your intensive care unit for the COVID-19 pandemic: practical considerations and strategies

et al. 2020

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The coronavirus disease 2019 has rapidly evolved into a worldwide pandemic. Preparing intensive care units (ICU) is an integral part of any pandemic response. In this review, we discuss the key principles and strategies for ICU preparedness. We also describe our initial outbreak measures and share some of the challenges faced. To achieve sustainable ICU services, we propose the need to 1) prepare and implement rapid identification and isolation protocols, and a surge in ICU bed capacity; (2) provide a sustainable workforce with a focus on infection control; (3) ensure adequate supplies to equip ICUs and protect healthcare workers; and (4) maintain quality clinical management, as well as effective communication.

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Section: Family Engagementmentioning

confidence: 99%

Preparing your intensive care unit for the COVID-19 pandemic: practical considerations and strategies

et al. 2020

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“…The treatment of underlying medical conditions and non-pharmacological issues, like noise, light, sleep and mobility, are cardinal aspects of delirium management. To improve ICU patient outcomes, including with respect to delirium, an evidence-based organizational approach referred to as the ABCDEF bundle ( A ssess for and manage pain, B oth Spontaneous Awakening Trials (SAT) & Spontaneous Breathing Trials (SBT), C hoice of appropriate sedation, D elirium monitoring, and E arly mobility and exercise, F amily engagement) has been proposed (50). …”

Section: Deliriummentioning

confidence: 99%

Intensive Care Unit Delirium and Intensive Care Unit–Related Posttraumatic Stress Disorder

Marra

Pandharipande

Patel

2017

Surgical Clinics of North America

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SYNOPSIS Delirium is one of the most common behavioral manifestations of acute brain dysfunction in Intensive Care Unit (ICU) and is a strong predictor of worse outcome. Routine monitoring for delirium is recommended for all ICU patients using validated tools (e.g., CAM-ICU, ICDSC). In delirious patients, a search for all reversible precipitants is the first line of action and pharmacological treatment should be considered when all causes have been ruled out, and not contraindicated. Long-term morbidity, in the forms of cognitive, physical and psychological impairments, has significant consequences for survivors of critical illness and for their caregivers. ICU patients may develop PTSD anchored to their critical illness experience, with ICU-related PTSD incidence rates of 10%. Using ICU diaries during a critical illness may minimize the occurrence of future ICU-related PTSD.

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“…There is strong clinical and physiologic plausibility that interventions considered as best practice with respect to short-term outcomes will also translate into improved long-term mortality and morbidity. Credible in-hospital interventions for which long-term consequences should be considered include (but are not limited to) (a) sepsis screening and detection strategies, (b) ICU triage and use of ICU, about which there is conflicting evidence in terms of short-term mortality in the United States and France, at least among elderly patients [173,174], (c) alternative antibiotic regimens, including empiric strategies, culture guidance, and de-escalation strategies, and the ABCDEF bundle [175]. Ultimately, however, our knowledge about the relationship between in-hospital interventions and long-terms outcomes is limited, which precludes any definitive statements about the impact of such interventions.…”

Section: Are There Potential In-hospital Interventions That Can Impacmentioning

confidence: 99%

Surviving sepsis campaign: research priorities for sepsis and septic shock

et al. 2018

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Objective: To identify research priorities in the management, epidemiology, outcome and underlying causes of sepsis and septic shock.Design: A consensus committee of 16 international experts representing the European Society of Intensive Care Medicine and Society of Critical Care Medicine was convened at the annual meetings of both societies. Subgroups had teleconference and electronic-based discussion. The entire committee iteratively developed the entire document and recommendations.Methods: Each committee member independently gave their top five priorities for sepsis research. A total of 88 suggestions (ESM 1 -supplemental table 1) were grouped into categories by the committee co-chairs, leading to the formation of seven subgroups: infection, fluids and vasoactive agents, adjunctive therapy, administration/epidemiology, scoring/identification, post-intensive care unit, and basic/translational science. Each subgroup had teleconferences to go over each priority followed by formal voting within each subgroup. The entire committee also voted on top priorities across all subgroups except for basic/translational science. Results:The Surviving Sepsis Research Committee provides 26 priorities for sepsis and septic shock. Of these, the top six clinical priorities were identified and include the following questions: (1) can targeted/personalized/precision medicine approaches determine which therapies will work for which patients at which times?; (2) what are ideal endpoints for volume resuscitation and how should volume resuscitation be titrated?; (3) should rapid diagnostic tests be implemented in clinical practice?; (4) should empiric antibiotic combination therapy be used in sepsis or septic shock?; (5) what are the predictors of sepsis long-term morbidity and mortality?; and (6) what information identifies organ dysfunction?Conclusions: While the Surviving Sepsis Campaign guidelines give multiple recommendations on the treatment of sepsis, significant knowledge gaps remain, both in bedside issues directly applicable to clinicians, as well as understanding the fundamental mechanisms underlying the development and progression of sepsis. The priorities identified represent a roadmap for research in sepsis and septic shock.

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The ABCDEF Bundle in Critical Care

Cited by 493 publications

References 77 publications

Preparing your intensive care unit for the COVID-19 pandemic: practical considerations and strategies

Preparing your intensive care unit for the COVID-19 pandemic: practical considerations and strategies

Intensive Care Unit Delirium and Intensive Care Unit–Related Posttraumatic Stress Disorder

Surviving sepsis campaign: research priorities for sepsis and septic shock

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