Strategies to Optimize ICU Liberation (A to F) Bundle Performance in Critically Ill Adults With Coronavirus Disease 2019

Critical Care Explorations
John W DevlinJohn C Lin

Abstract

The severe acute respiratory syndrome coronavirus 2 pandemic has stretched ICU resources in an unprecedented fashion and outstripped personal protective equipment supplies. The combination of a novel disease, resource limitations, and risks to medical personnel health have created new barriers to implementing the ICU Liberation ("A" for Assessment, Prevention, and Manage pain; "B" for Both Spontaneous Awakening Trials and Spontaneous Breathing Trials; "C" for Choice of Analgesia and Sedation; "D" for Delirium Assess, Prevent, and Manage; "E" for Early Mobility and Exercise; and "F" for Family Engagement and Empowerment [ABCDEF]) Bundle, a proven ICU care approach that reduces delirium, shortens mechanical ventilation duration, prevents post-ICU syndrome, and reduces healthcare costs. This narrative review acknowledges barriers and offers strategies to optimize Bundle performance in coronavirus disease 2019 patients requiring mechanical ventilation. The most relevant literature, media reports, and author experiences were assessed for inclusion in this narrative review including PubMed, national newspapers, and critical care/pharmacology textbooks. Uncertainty regarding coronavirus disease 2019 clinical course, shifts in attitude...Continue Reading

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Aug 28, 2020·Journal of Intensive Care Medicine·Mahmoud A AmmarAbdalla A Ammar
Nov 11, 2020·Intensive Care Medicine·Gerald ChanquesJohn P Kress
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Jun 12, 2021·Critical Care Medicine·Matthew F MartE Wesley Ely
Aug 19, 2021·The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association·Jamie WilcoxJohn L Margetis

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Methods Mentioned

BETA
Sedation

Software Mentioned

Bundle

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