ABCDEF Bundle and Supportive ICU Practices for Patients With Coronavirus Disease 2019 Infection: An International Point Prevalence Study

Liu, Keibun; Nakamura, Kensuke; Katsukawa, Hajime; Elhadi, Muhammed; Nydahl, Peter; Ely, E. Wesley; Kudchadkar, Sapna R.; Takahashi, Kunihiko; Inoue, Shigeaki; Lefor, Alan Kawarai; Kesecioğlu, Jozef; Nishida, Osamu

doi:10.1097/cce.0000000000000353

Cited by 57 publications

(55 citation statements)

References 52 publications

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“…In addition, this bundle performance decreased the readmission to the ICU and discharge to a facility other than home [74]. However, the ABCDEF bundle was not sufficiently conducted in the COVID-19 pandemic with the bundle performance at A, 45%; B, 28%; C, 52%; D, 35%; E, 47%; and F, 16% [75]. These implementations were lower in the ICU where more beds were allocated for COVID-19 infections.…”

Section: Implementation Of the Abcdef Bundlementioning

confidence: 98%

“…As a result, the frequency of unplanned extubations in COVID-19-infected patients was 13%, which is three times higher than other patients [81]. In this situation, physical restraints were reportedly used in 28% of mechanically ventilated patients [75]. A sedative in mechanically ventilated patients was excessively used with propofol 48%, dexmedetomidine 29%, and midazolam 7.7% [82].…”

Section: Analgesia Sedation and Delirium Carementioning

confidence: 99%

“…Even during the COVID-19 pandemic, ICU diaries have positive effects (e.g., patients understand what actually happened to fill in the memory gap/lack and cope with overwhelming emotional experience) by daily describing patient's condition, and providing messages of hope for recovery, and nursing care in the diary [90]. However, the ICU diary was used in 25% of COVID-19-infected patients [75]. ICU nurses can connect patients with their families through the ICU diary.…”

Section: Nursing Care and Icu Diarymentioning

confidence: 99%

See 2 more Smart Citations

Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019 (COVID-19) Pandemic: A Review of Recent Advances and Perspectives

Nakanishi

Liu

Kawakami

et al. 2021

JCM

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Intensive care unit survivors experience prolonged physical impairments, cognitive impairments, and mental health problems, commonly referred to as post-intensive care syndrome (PICS). Previous studies reported the prevalence, assessment, and prevention of PICS, including the ABCDEF bundle approach. Although the management of PICS has been advanced, the outbreak of coronavirus disease 2019 (COVID-19) posed an additional challenge to PICS. The prevalence of PICS after COVID-19 extensively varied with 28–87% of cases pertaining to physical impairments, 20–57% pertaining to cognitive impairments, and 6–60% pertaining to mental health problems after 1–6 months after discharge. Each component of the ABCDEF bundle is not sufficiently provided from 16% to 52% owing to the highly transmissible nature of the virus. However, new data are emerging about analgesia, sedation, delirium care, nursing care, early mobilization, nutrition, and family support. In this review, we summarize the recent data on PICS and its new challenge in PICS after COVID-19 infection.

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Section: Implementation Of the Abcdef Bundlementioning

confidence: 98%

Section: Analgesia Sedation and Delirium Carementioning

confidence: 99%

Section: Nursing Care and Icu Diarymentioning

confidence: 99%

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Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019 (COVID-19) Pandemic: A Review of Recent Advances and Perspectives

Nakanishi

Liu

Kawakami

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

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“…In addition to direct structural changes being associated with delirium and other neurologic changes in patients with covid-19, patients with severe disease may receive deeper sedation, fewer breathing trials, and more limited mobility sessions than other critically ill patients. A worldwide two day prevalence study of ABCDEF* bundle practices across 212 ICUs in 38 countries found implementation rates to be low: pain assessment (45%), paired spontaneous awakening trial and spontaneous breathing trial (28%), sedation assessment (52%), delirium assessment (38%), early mobility and exercise (16% if patient being mechanically ventilated), and family engagement and empowerment (16%) 31. In the face of staggering numbers of critically ill patients with covid-19 met with an imbalance of staffing and resources to meet the demand,32 patients are unlikely to receive the usual quality of care.…”

Section: Introductionmentioning

confidence: 99%

Delirium and long term cognition in critically ill patients

Wilcox

Girard

Hough

2021

BMJ

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Delirium, a form of acute brain dysfunction, is very common in the critically ill adult patient population. Although its pathophysiology is poorly understood, multiple factors associated with delirium have been identified, many of which are coincident with critical illness. To date, no drug or non-drug treatments have been shown to improve outcomes in patients with delirium. Clinical trials have provided a limited understanding of the contributions of multiple triggers and processes of intensive care unit (ICU) acquired delirium, making identification of therapies difficult. Delirium is independently associated with poor long term outcomes, including persistent cognitive impairment. A longer duration of delirium is associated with worse long term cognition after adjustment for age, education, pre-existing cognitive function, severity of illness, and exposure to sedatives. Interestingly, differences in prevalence are seen between ICU survivor populations, with survivors of acute respiratory distress syndrome experiencing higher rates of cognitive impairment at early follow-up compared with mixed ICU survivor populations. Although cognitive performance improves over time for some ICU survivors, impairment is persistent in others. Studies have so far been unable to identify patients at higher risk of long term cognitive impairment; this is an active area of scientific investigation.

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“…PICS is expected to be a major issue in the era of COVID-19, and the establishment of preventive measures through the surveillance of current situations is warranted [5,6]. Although evidence-based and supportive care in the ICU, such as the ABCDEF bundle, is expected to decrease PICS, a point prevalence study showed low implementation of the bundle [7]. The details of the long-term prognosis and PICS after COVID-19 infection have not been investigated in Japan.…”

Section: Introductionmentioning

confidence: 99%

Roles of Early Mobilization Program in Preventing Muscle Weakness and Decreasing Psychiatric Disorders in Patients with Coronavirus Disease 2019 Pneumonia: A Retrospective Observational Cohort Study

Kotani

Sugiyama

Matsuzaki

et al. 2021

JCM

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Although many coronavirus 2019 patients have experienced persistent symptoms and a long-term decline in quality of life after discharge, the details of these persistent symptoms and the effect of early rehabilitation are still unclear. We conducted a single-center, retrospective observational study to investigate the prevalence of persistent symptoms three months after discharge from the intensive care unit by checking the medical records. All patients received an early mobilization program. Four out of 13 patients (31%) had postintensive care syndrome. No patients had muscle weakness, and 11 patients (85%) returned to their previous work. However, psychiatric disorder, such as anxiety (23%) and posttraumatic stress disorder (15%), were observed. Eleven patients claimed persistent symptoms, including fatigue and numbness in the extremities. Our results suggest that the implementation of an early rehabilitation program plays some role in preventing muscle weakness and that decreasing psychiatric disorders should be a next target of patient care in the intensive care unit.

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ABCDEF Bundle and Supportive ICU Practices for Patients With Coronavirus Disease 2019 Infection: An International Point Prevalence Study

Abstract: Supplemental Digital Content is available in the text.

Cited by 57 publications

References 52 publications

Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019 (COVID-19) Pandemic: A Review of Recent Advances and Perspectives

Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019 (COVID-19) Pandemic: A Review of Recent Advances and Perspectives

Delirium and long term cognition in critically ill patients

Roles of Early Mobilization Program in Preventing Muscle Weakness and Decreasing Psychiatric Disorders in Patients with Coronavirus Disease 2019 Pneumonia: A Retrospective Observational Cohort Study

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