ABCDE and ABCDEF Care Bundles: A Systematic Review of the Implementation Process in Intensive Care Units
Medicine
Moraes, F. D. S., Marengo, L. L., et al. (2022).
Medicine, 101(25), e29499.
<div>This systematic review and meta-analysis investigates the effects of the Awakening and Breathing Coordination of daily sedation and ventilator removal trials, Delirium monitoring and management, and Early mobility and exercise (ABCDE) and Assessment, prevent and manage pain, Both spontaneous awakening and spontaneous breathing trials, Choice of analgesia and sedation, assess, prevent and manage Delirium, Early mobility and exercise, Family engagement (ABCDEF) care bundles on outcomes for individuals with delirium.</div>
PROSUC/CAPES/UNISO (Brazil)
From database inception to June 2018
<div>Randomized controlled trials (RCTs), non-RCTs, controlled before-after studies, interrupted time series, and repeated measurement studies were searched preferentially; although, uncontrolled studies were considered.</div>
13 studies in the qualitative synthesis and 7 in the meta-analysis
<div>Meta-analysis of 5 studies revealed that compared to usual care, ABCDE and ABCDEF bundles resulted in:</div>
<div>
<ul>
<li>significantly lower incidence of delirium (OR = 0.15);</li>
<li>significantly increased early mobilization (OR = 0.47);</li>
<li>significantly decreased intensive care unit (ICU) mortality (OR = 0.46) and hospital mortality (OR = 0.52); and</li>
<li>no significant differences in ICU or hospital length of stay, time on mechanical ventilation, or sedation outcomes.</li>
</ul>
<div>Conclusions could not be drawn regarding the effectiveness and safety of the bundles due to methodological bias of the included studies.</div>
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