SynthesisChest2017
Identifying Barriers to Delivering the Awakening and Breathing Coordination, Delirium, and Early Exercise/Mobility Bundle to Minimize Adverse Outcomes for Mechanically Ventilated Patients: A Systematic Review.
Synthesis in Chest, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05688267 (Effects of Continuous Mobility Training in Individuals With Prolonged Mechanical Ventilation), which is not on this map. Cited by 87 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Continuous Mobility Training in Individuals With Prolonged Mechanical Ventilation : A Randomized Controlled Trial
Who cites it
87 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Acceptability and Fidelity of a Cognitive Rehabilitation Intervention During and After Intensive Care: A Feasibility Evaluation.Nursing in critical care · 2026Trial
- Implementation of coordinated spontaneous awakening and breathing trials using telehealth-enabled, real-time audit and feedback for clinician adherence (TEACH): a type II hybrid effectiveness-implementation cluster-randomized trial.Implementation science : IS · 2023Trial
- Multicentre pilot randomised clinical trial of early in-bed cycle ergometry with ventilated patients.BMJ open respiratory research · 2019Trial
- Trial
- Discordance between early mobility protocol expectations and nurse-led mobilizations of critically ill children: A quality improvement initiative.World journal of critical care medicine · 2026Article
- Early Mobilization and Rehabilitation Practices of Adult Patients Admitted to the ICU in Japan: A 1-Day Multicenter Point-Prevalence Study.Critical care explorations · 2026Article
- Barriers and Facilitators to ICU Liberation Bundle Implementation and Compliance.Critical care explorations · 2026Article
- A rapid evaluation of quality of sedation and ventilation care processes for critically ill patients in Vietnam.PloS one · 2026Article
- Knowledge, attitudes, and practices of ICU nurses regarding daily sedation interruption: a cross-sectional study.Frontiers in medicine · 2026Article
- Article
- Interprofessional Simulation-Based Training to Facilitate ABCDEF Bundle Implementation.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2025Article
- Impact of ICU Length of Stay and Illness Severity on Rehabilitation Progress and Functional Recovery: A Secondary Analysis of the Japanese Rehabilitation and Risk Factors on the Post-Intensive Care Syndrome (J-RELIFE) Prospective Registry.Critical care explorations · 2025Article
- Effects of continuous mobility training versus hand bicycle exercise in individuals with prolonged mechanical ventilation: A randomized-controlled trial.Turkish journal of physical medicine and rehabilitation · 2025Article
- Normalizing daily awakening and breathing coordination at 15 heterogenous ICUs: a multicenter post-implementation survey.Implementation science communications · 2025Article
- Developing and validating machine learning models to predict next-day extubation.Scientific reports · 2025Article
- Association of Central Nervous System-Related Biomarkers With Hospital Delirium in Patients With Respiratory Failure in the ICU.CHEST critical care · 2025Article
- One-year outcomes in sepsis: a prospective multicenter cohort study in Japan.Journal of intensive care · 2025Article
- Article
- Exploring Cognitive Stimulation as a Therapy for the Prevention of Delirium in a Hospital Setting: A Narrative Review.Behavioral sciences (Basel, Switzerland) · 2025Review
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundImproved outcomes are associated with the Awakening and Breathing Coordination, Delirium, and Early exercise/mobility bundle (ABCDE); however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and to provide a resource to guide clinicians in overcoming barriers to implementation.
methodsWe searched MEDLINE via PubMed, CINAHL, and Scopus for original research articles from January 1, 2007, to August 31, 2016, that identified barriers to ABCDE implementation for adult patients in the ICU. Two reviewers independently reviewed studies, extracted barriers, and conducted thematic content analysis of the barriers, guided by the Consolidated Framework for Implementation Research. Discrepancies were discussed, and consensus was achieved.
resultsOur electronic search yielded 1,908 articles. After applying our inclusion/exclusion criteria, we included 49 studies. We conducted thematic content analysis of the 107 barriers and identified four classes of ABCDE barriers: (1) patient-related (ie, patient instability and safety concerns); (2) clinician-related (ie, lack of knowledge, staff safety concerns); (3) protocol-related (ie, unclear protocol criteria, cumbersome protocols to use); and, not previously identified in past reviews, (4) ICU contextual barriers (ie, interprofessional team care coordination).
conclusionsWe provide the first, to our knowledge, systematic differential diagnosis of barriers to ABCDE delivery, moving beyond the conventional focus on patient-level factors. Our analysis offers a differential diagnosis checklist for clinicians planning ABCDE implementation to improve patient care and outcomes.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.