Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility Bundle
A bundle of interventions reduce the effects of prolonged sedation, mechanical ventilation, and immobility in critically ill intensive care patients.
Adult critically ill patients in an intensive care unit (ICU) can experience functional declines such as muscle weakness or experience delirium as a result of their stay. Patients who can breathe without ventilation are more likely to be mobilized and less likely to experience delirium. A small set of evidence-based practices—called a bundle—can improve those patient outcomes.
Researchers wanted to determine if a bundle of interventions could safely and effectively be applied to all critically ill patients, whether on a ventilator or not. The ABCDE bundle includes Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility.
Compared to “usual care,” the bundle was found to have:
- Increased by three the number of days of breathing without mechanical assistance.
- Decreased delirium by half the odds.
- Increased mobility, doubling the odds of a patient getting out of bed at least once during an ICU stay.
"The ABCDE bundle appears to be a valuable tool in the management of critically ill patients,” the researchers concluded.
About the Study:
This 18-month prospective before–after study (November 2010 to May 2012) followed 286 patients in a 624-bed hospital’s adult critical care units.