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About ICU Liberation

About ICU Liberation

The Society of Critical Care Medicine's ICU Liberation campaign aims to liberate patients from the harmful effects of pain, agitation, and delirium in the intensive care unit.

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The Society of Critical Care Medicine’s (SCCM) ICU Liberation Campaign is an ongoing initiative that aims to liberate patients from the harmful effects of an ICU stay and provides strategies in a comprehensive bundle for the entire multiprofessional critical care team.

Based on the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PADIS) Guidelines, the ICU Liberation Campaign offers numerous tools and resources to educate the team on implementing these life-saving interventions.

Goals and Impact

The primary goals of the ICU Liberation Campaign are:

  • Liberate Patients: Address and mitigate pain, agitation/sedation, delirium, immobility, and sleep disruption in the ICU.
  • Reduce PICS: Decrease the risk of post-intensive care syndrome (PICS), which includes new or increased physical, cognitive, or mental health impairments after ICU hospitalization.

Who benefits from the ICU Liberation Campaign?

ICU teams, patients, families, and hospital administrators all benefit from the ICU Liberation Campaign. It is for ICU teams seeking to improve short- and long-term outcomes for patients during their ICU stay and beyond, allowing them to not only survive, but thrive. These interventions have also been associated with a reduction in administrative costs for hospitals and third-party payers.

Why should you implement the ICU Liberation Campaign?

Studies have shown that implementing ventilator weaning protocols, maintaining light levels of sedation, and preventing and managing delirium can improve patient outcomes. Early mobilization and family engagement also play key roles in reducing long- and short-term consequences of an ICU stay. The greatest benefit occurs when these interventions are combined.

History and Evolution

  • 2013: SCCM launched the ICU Liberation Campaign, based on the Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU (PAD guidelines) published in Critical Care Medicine. The original ABCDE Bundle, often referred to as the A-E Bundle, was introduced to complement these guidelines.
  • 2014: SCCM received a grant from the Gordon and Betty Moore Foundation to study the integration and dissemination of the 2013 PAD guidelines. The A-E Bundle was expanded to include Family engagement, evolving into the ABCDEF Bundle or A-F Bundle. Over 20 months, 77 ICUs collected data and shared best practices, leading to significant and meaningful outcomes such as improved survival rates, reduced mechanical ventilation use, and decreased ICU readmissions.
  • 2017: An SCCM committee was established to help advance the ICU Liberation Campaign
  • 2018: The PAD guidelines were updated to the PADIS Guidelines, further informing the evolution of the ICU Liberation Bundle.
 
 
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