Benefits of the ABCDE Bundle in ICU Patients

The Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle has been proposed as a strategy to reduce delirium, liberate patients from the ventilator and improve outcomes for intensive care unit (ICU) patients. Balas and colleagues conducted a prospective before-after study at a tertiary medical center to determine the safety and impact of the ABCDE bundle implementation for ICU patients.

They found that critically ill patients managed with the ABCDE bundle spent more days breathing without assistance and experienced less delirium than patients treated with usual care. Some of the limitations of this study are the small sample size and the inclusion of nonventilated and oncology/hematology patients. Although the patient population was small, it represented a heterogeneous population, with more than 40% of patients having had surgery.  Ultimately, multicomponent ventilator liberation and “animation” strategies such as the ABCDE bundle are likely to become an integral component of ICU care if the safety and effectiveness demonstrated in this study can be reproduced.

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