2025 Multiprofessional Critical Care Review: Adult Online-7: Liberation from Mechanical Ventilation Using the ABCDEF Bundle

Video Transcription

Video Summary

Dr. Michelle Vallis, an associate professor at The Ohio State University College of Nursing, presented strategies for using the ABCDF bundle to liberate patients from mechanical ventilation. The bundle aims to prevent ICU-acquired delirium and other symptoms experienced by patients during their ICU stay. The ABCDF bundle consists of assess, prevent, and manage pain; awakening and breathing trials; choice of analgesia and sedation; delirium management; early mobility and exercise; and family engagement. Implementing the bundle has been shown to improve patient outcomes, including decreased mortality, delirium, and physical restraints, and improved mechanical ventilation liberation. However, the implementation of the bundle faces challenges. The ICU Liberation Collaborative, a large quality improvement project, found that only a small percentage of patients received the complete bundle. Individual variability and culture within ICU settings contribute to the adoption and success of the bundle. Various implementation strategies can be employed to improve bundle adoption, such as education and training, providing feedback, and engaging champions. Overcoming barriers and promoting the implementation of the bundle can lead to better patient outcomes and improve ICU care.

Keywords

ABCDF bundle

mechanical ventilation

ICU-acquired delirium

patient outcomes

ICU Liberation Collaborative

implementation strategies

early mobility

family engagement

quality improvement

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