NDLI: Sedation, delirium and mechanical ventilation: the 'ABCDE' approach.

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Ventilator-associated pneumonia: role of positioning.

Sedation, delirium and mechanical ventilation: the 'ABCDE' approach.

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Sedation, delirium and mechanical ventilation: the 'ABCDE' approach.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Morandi, Alessandro Brummel, Nathan E. Ely, E. Wesley
Description	Country affiliation: United States Author Affiliation: Morandi A ( Center for Health Services Research, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. alessandro.morandi@vanderbilt.edu)
Abstract	PURPOSE OF REVIEW: Delirium and ICU-acquired weakness are frequent in critically ill mechanically ventilated patients. The number of mechanically ventilated patients is increasing, placing more patients at risk for these adverse outcomes. Sedation is given to ensure comfort and to minimize distress, but is linked to delirium and immobility. We review recent findings on the management of mechanically ventilated patients focusing on strategies that may improve neurologic and functional outcomes in critically ill patients. RECENT FINDINGS: We present the evidence-based 'ABCDE' bundle, an integrated and interdisciplinary approach to the management of mechanically ventilated patients. Spontaneous awakening and breathing trials have been combined into 'awake and breathing coordination', shortening the duration of mechanical ventilation, ICU and hospital length of stay and improving survival. The choice of -2 agonists reduces ICU delirium and duration of mechanical ventilation. Delirium monitoring improves recognition of this disorder, but data on pharmacologic treatment are mixed. Early mobility and exercise may reduce physical dysfunction and delirium rates. SUMMARY: Outcomes of critically ill patients can be improved by applying evidence-based therapies for the 'liberation' from mechanical ventilation and sedation, and the 'animation' through early mobilization. Clinicians should be aware of organizational approaches such as the 'ABCDE' bundle to improve the management of mechanically ventilated patients.
File Format	HTM / HTML
ISSN	10705295
Issue Number	1
Volume Number	17
e-ISSN	15317072
Journal	Current Opinion in Critical Care
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2011-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Critical Care Deep Sedation Adverse Effects Delirium Prevention & Control Respiration, Artificial Critical Illness Therapy Etiology Evidence-based Medicine Humans Intensive Care Units Journal Article Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Research Support, U.s. Gov't, Non-p.h.s. Review
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine

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