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A Systemic Approach: ABCDEF Bundle

  • Matteo Manici
  • Alessandra Negro
  • Stefano Bambi
Chapter

Abstract

ABCDEF bundle is an evidence-based, integrated, systemic, and interdisciplinary approach to the management of mechanically ventilated patients. The acronym ABCDEF stands for the following: ABC, awake and breathing coordination; D, delirium monitoring; E, early mobility and exercise; and F, family involvement.

Spontaneous awakening and breathing trials have been combined into awake and breathing coordination, with the aim to reduce the duration of mechanical ventilation and ICU and hospital length of stay and improve the survival rates. Delirium monitoring improves the recognition of this disorder, but data on pharmacologic treatment are conflicting. Early mobility and exercise may reduce physical dysfunction and delirium rates. Family involvement in patients’ care can improve patient’s process of recovery.

Many institutions have implemented the concept of ABCDEF bundle through different practice guidelines. The main models are promoted by the American Association of Critical-Care Nurses (ACCN) and Society of Critical Care Medicine (SCCM).

In this chapter, the authors will propose a mixed model for the ABCDEF bundle implementation.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Matteo Manici
    • 1
  • Alessandra Negro
    • 2
    • 3
  • Stefano Bambi
    • 4
  1. 1.Anesthesia, Intensive Care and Hub Pain ServiceUniversity Hospital of ParmaParmaItaly
  2. 2.Vita-Salute San Raffaele UniversityMilanItaly
  3. 3.IRCCS San Raffaele HospitalMilanoItaly
  4. 4.Emergency & Trauma ICU, University Hospital CareggiFlorenceItaly

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