Modrykamien Ariel M
Department of Pulmonary and Critical Care, Baylor University Medical Center, Dallas, TE 75246, United States.
World J Crit Care Med. 2023 Mar 9;12(2):41-52. doi: 10.5492/wjccm.v12.i2.41.
Survivors of prolonged intensive care unit (ICU) admissions may present undesirable long-term outcomes. In particular, physical impairment and cognitive dysfunction have both been described in patients surviving episodes requiring mechanical ventilation and sedation. One of the strategies to prevent the aforementioned outcomes involves the implementation of a bundle composed by: (1) Spontaneous awakening trial; (2) Spontaneous breathing trial; (3) Choosing proper sedation strategies; (4) Delirium detection and management; (5) Early ICU mobility; and (6) Family engagement (ABCDEF bundle). The components of this bundle contribute in shortening length of stay on mechanical ventilation and reducing incidence of delirium. Since the first description of the ABCDEF bundle, other relevant therapeutic factors have been proposed, such as introducing music therapy. This mini-review describes the current evidence supporting the use of the ABCDEF bundle, as well as current knowledge on the implementation of music therapy.
长期入住重症监护病房（ICU）的幸存者可能会出现不良的长期后果。特别是，在需要机械通气和镇静的患者存活期，均出现过身体损伤和认知功能障碍的情况。预防上述后果的策略之一是实施一套综合措施，包括：（1）自主唤醒试验；（2）自主呼吸试验；（3）选择适当的镇静策略；（4）谵妄的检测与管理；（5）早期ICU活动；以及（6）家属参与（ABCDEF综合措施）。该综合措施的各个组成部分有助于缩短机械通气时间和降低谵妄发生率。自首次描述ABCDEF综合措施以来，还提出了其他相关治疗因素，如引入音乐疗法。本综述介绍了支持使用ABCDEF综合措施的现有证据，以及目前关于音乐疗法实施的知识。
