The Science, Why, and What of ICU Liberation and the ABCDEF Bundle for Patients and Families

HAWAII PLENARY on ICU LIBERATION ABCDEF and PICS before over 2,000 people January 2017: Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called post-intensive care syndrome (PICS).  PICS patients are suffering from impairments in these domains of life: cognitive (impaired executive functioning), emotional (depression, anxiety, post-traumatic stress disorder), and physical (weakness, myopathy, and neuropathy).  They cannot resume their previous life including ADLs and IADLs. The ICU Liberation Collaborative was a real-world quality improvement initiative implemented across 76 ICUs designed to engage strategically the ABCDEF bundle from 2015-17 ( A – Assess, Prevent and Manage Pain, B – Both spontaneous awakening trials and spontaneous breathing trials, C – Choice of Sedation, D – Delirium: Assess, Prevent and Manage, E –  Early Mobility and Exercise, and  F –  Family Engagement and Empowerment) through team and evidence-based care.