What is Evidence-based ICU care?
The ABCDEF bundle is a comprehensive approach to managing patients with ARDS in the ICU that involves six key components. In addition to the components previously mentioned, two additional components are often included in the bundle.
A – Assess, Prevent, and Manage Pain
B – Both Spontaneous Awakening Trial (SAT) and Spontaneous Breathing Trial (SBT)
C – Choice of analgesia and sedation, Comfort
D – Delirium: Assess, Prevent, and Manage
E – Early mobility and exercise
F – Family engagement and empowerment
Nutrition therapy: providing adequate nutrition and addressing malnutrition is essential to facilitate the recovery of critically ill patients, and is often incorporated with the ABCDEF bundle.
ICU diary: keeping a diary of the patient’s ICU experience by nurses, patient family members, and relevant staff in ICU can help promote patient engagement, improve their psychological well-being, and facilitate post-ICU recovery.
The ABCDEF bundle, nutrition therapy, ICU diary, and other ICU care should work together to address the various aspects of patient care in the ICU. The bundle has been shown to improve patient outcomes and promote successful recovery and reintegration into society. Implementation of the ABCDEF bundle requires a multidisciplinary approach and ongoing communication among healthcare providers, patients, and their families.
- Ely EW: The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families. Crit Care Med 2017; 45:321–330
- Vasilevskis EE, Ely EW, Speroff T, et al.: Reducing iatrogenic risks: ICU-acquired delirium and weakness–crossing the quality chasm. Chest 2010; 138:1224–1233
- McClave SA, Taylor BE, Martindale RG et al.: Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr 40; 159–211: 2016.
- Brandao Barreto B, Luz M, Alves Valente do Amaral Lopes S, et al: Exploring Patients’ Perceptions on ICU Diaries: A Systematic Review and Qualitative Data Synthesis. Crit Care Med. 2021 Jul 1;49(7):e707-e718.