مراقبت به وسیله باندل ICU (ABCDEF) در بخش مراقبت های ویژه کودکان
کد: G-1117
نویسندگان: لعیا نادرپور © ℗, زهرا مظهری
زمان بندی: زمان بندی نشده!
دانلود: دانلود پوستر
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خلاصه مقاله
Background: The Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Sedation, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Engagement/Empowerment (ABCDEF) bundle is the foundation of the Society of Critical Care Medicine’s ICU Liberation collaborative. ICU Liberation focuses on comprehensive, interprofessional team collaborative care to achieve integration of all six Bundle elements into the daily care of all ICU patients such as sepsis or specific hospital acquired complications, even for those patients not requiring mechanical ventilation support or not receiving scheduled or continuous infusion analgesics/anxiolytics, the elements of the Bundle remain applicable. The concept of ICU Liberation gained significant attention in the adult critical care literature and has more recently engaged pediatric critical care practitioners. A strong evidence base in the adult critical care literature supports the positive clinical impact of each individual ABCDEF bundle component as well as the collective bundle. Method: Electronic search were conducted using the following databases, Google scholar and Pub med, with the following key words were used in the search: ABCDEF Bundle, intensive care unit liberation, pediatric critical care, pediatric, ICU and delirium. In this search were used 15 articles in pediatric. Result: PICU Liberation and implementation of the A-F Bundle in critically ill children is feasible. Every 10% increase in bundle compliance over the entire PICU stay and on any one PICU day is associated with increased overall and next-day survival. ABCDEF Bundle is applicable to children. Although enhanced Bundle utilization correlated with decreased mortality, increased utilization did not correlate with duration of mechanical ventilation, PICU LOS or delirium incidence. Conclusion: Widespread adoption of the Bundle as a whole among pediatric critical care providers and multicenter evidence demonstrating clinical efficacy remain lacking. It is also important to understand barriers for implementation of the ABCDEF bundle and determine whether cultural and regional differences affect implementation. There is an urgency for additional research on the efficacy of specific components including Breathing, Delirium, and Early Mobility and full ABCDEF bundle implementation in critically ill children. Key Words: ABCDEF Bundle, intensive care unit liberation, pediatric critical care.
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