Long-term morbidity, long-term cognitive impairment, and hospitalization-associated disability are common occurrences in the survivors of critical illness, with significant consequences for patients and caregiver’s quality of life.
ICU survivorship has become a top concern and methods to optimize patient recovery and outcomes are important objectives for the health provider, families, and researchers. Inadequately treated pain, excessive sedation, delirium, and reduced mobilization have emerged as risk factors for acute muscle wasting and weakness, persisting physical dysfunction, and cognitive decline. The ABCDEF bundle represents an evidence-based guide for clinicians to focus their attention on some fundamental elements which are commonly overlooked and underestimated in ICU clinical practice even if they dramatically impact on patient’s recovery and outcomes. The ABCDEF bundle includes the following elements: A - Assessment and management of pain, B - Both Spontaneous Awakening Trials (SAT) & Spontaneous Breathing Trials (SBT), C - Choice of sedation and analgesia, D - Delirium monitoring and management, E - Early mobility and F - Family engagement. The bundle has individual components that are clearly defined and help empower a multidisciplinary approach that includes not only the clinicians but also the families in a wider perspective of shared care of critical illness. Recently, the R element was added for Respiratory drive (ABCDEF-R) to underline the challenges associated with the implementation of the bundle in patients with ARDS.
However, the current implementation of the ABCDEF bundle varies across its individual components, especially during the COVID-19 pandemic and there is a yet incomplete cultural shift from a disease-centered approach to a patient- and family-centered ICU liberation strategy.
The aim of this thematic series is to report clinical practice suggestions, based on the current literature and clinical expertise, to enhance the adoption of the ABCDEF bundle, and to identify specific targets for quality improvement.
Furthermore, in this Research Topic we aim to fill the research gap on the ABCDEF bundle particularly concerning the management of sedation, the assessment of delirium, the application of early mobility, the ICU visitation policy, and the engagement of family members as partners of the ICU team at the bedside.
Therefore, we welcome articles, reviews, and commentaries.
Long-term morbidity, long-term cognitive impairment, and hospitalization-associated disability are common occurrences in the survivors of critical illness, with significant consequences for patients and caregiver’s quality of life.
ICU survivorship has become a top concern and methods to optimize patient recovery and outcomes are important objectives for the health provider, families, and researchers. Inadequately treated pain, excessive sedation, delirium, and reduced mobilization have emerged as risk factors for acute muscle wasting and weakness, persisting physical dysfunction, and cognitive decline. The ABCDEF bundle represents an evidence-based guide for clinicians to focus their attention on some fundamental elements which are commonly overlooked and underestimated in ICU clinical practice even if they dramatically impact on patient’s recovery and outcomes. The ABCDEF bundle includes the following elements: A - Assessment and management of pain, B - Both Spontaneous Awakening Trials (SAT) & Spontaneous Breathing Trials (SBT), C - Choice of sedation and analgesia, D - Delirium monitoring and management, E - Early mobility and F - Family engagement. The bundle has individual components that are clearly defined and help empower a multidisciplinary approach that includes not only the clinicians but also the families in a wider perspective of shared care of critical illness. Recently, the R element was added for Respiratory drive (ABCDEF-R) to underline the challenges associated with the implementation of the bundle in patients with ARDS.
However, the current implementation of the ABCDEF bundle varies across its individual components, especially during the COVID-19 pandemic and there is a yet incomplete cultural shift from a disease-centered approach to a patient- and family-centered ICU liberation strategy.
The aim of this thematic series is to report clinical practice suggestions, based on the current literature and clinical expertise, to enhance the adoption of the ABCDEF bundle, and to identify specific targets for quality improvement.
Furthermore, in this Research Topic we aim to fill the research gap on the ABCDEF bundle particularly concerning the management of sedation, the assessment of delirium, the application of early mobility, the ICU visitation policy, and the engagement of family members as partners of the ICU team at the bedside.
Therefore, we welcome articles, reviews, and commentaries.