Current Concepts in Pediatric Critical Care-16: THRIVE and the ABCDEF Bundle

Video Transcription

Video Summary

In this video, Dr. Neelima Marupudi, an assistant professor of pediatrics, discusses the Thrive initiative and the ABCDEF bundle in pediatric intensive care units (PICUs). The Thrive initiative aims to provide resources and education for ICU patient survivors and their families to help them thrive after their stay in the ICU. The ABCDEF bundle is an approach to address post-intensive care syndrome and includes six components: assessment and management of pain (A), spontaneous breathing trial/extubation readiness (B), choice of analgesia and sedation (C), delirium assessment and management (D), early mobility (E), and family engagement (F).<br /><br />Dr. Marupudi explains each component in detail, discussing the challenges and evidence supporting its application in pediatric populations. For pain management (A), validated pain scales and alternative modalities are discussed. Spontaneous breathing trials and extubation readiness protocols (B) are explained, along with their benefits and barriers. The importance of using validated sedation scoring tools and goal-directed sedation (C) is emphasized. Delirium assessment (D), including screening tools and risk factors, is discussed. The benefits and challenges of early mobilization (E) are highlighted. Lastly, the importance of family engagement (F) and strategies for involving families in care are covered.<br /><br />Dr. Marupudi acknowledges that the implementation of the ABCDEF bundle in pediatric populations has unique challenges, such as heterogeneity in age, development, and diagnosis. However, she emphasizes the importance of multidisciplinary collaboration and consistent use of validated tools to optimize patient care and outcomes in the PICU. She also mentions the release of the Society of Critical Care Medicine's clinical practice guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients, and encourages healthcare providers to read and implement these guidelines.

Asset Caption

Neelima K. Marupudi, BA, MD

Keywords

Thrive initiative

ABCDEF bundle

pediatric intensive care

post-intensive care syndrome

pain management

family engagement

multidisciplinary collaboration

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