Evidence map›Paper›PMID 28787293›Full record

ArticleCritical care medicine2017

Worldwide Survey of the "Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment" (ABCDEF) Bundle.

Alessandro Morandi, Simone Piva, E Wesley Ely, Sheila Nainan Myatra, Jorge I F Salluh, Dawit Amare, Elie Azoulay, Giuseppe Bellelli, Akos Csomos, Eddy Fan and 21 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04217915 (A Survey of Management of Analgesia, Sedation and Delirium in ICU Patients in China), which is not on this map. Cited by 108 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
108citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04217915 unknown statusnot on this mapstarted 2021, after this paper: background citation

A Survey of Management of Analgesia, Sedation and Delirium in ICU Patients in China

TypeobservationalSponsorChina Medical University, ChinaRan2021 to 2021Enrolled800ConditionsDelirium on Emergence, Analgesia, Separation
3 · Its place in the literature

Who cites it

108 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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48 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Alessandro Morandi1Department of Rehabilitation, Ancelle Hospital, Cremona, Italy. 2Geriatric Research Group, Brescia, Italy. 3Department of Anesthesia, Critical Care and Emergency, SpedaliCivili University Hospital, Brescia, Italy. 4Division of Pulmonary and Critical Care and Health Services Research, Vanderbilt University and VA Geriatric Research Education Clinical Center (GRECC), Nashville, TN. 5Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, India. 6Department of Critical Care, D'or Institute for Research and Education and Post-Graduate Program Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 7Addis Hiwot General Hospital, Addis Ababa, Ethiopia. 8Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA team, Biostatistics and clinical epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France. 9School of Medicine and Surgery, University of Milano-Bicocca, Milano Geriatric Clinic, San Gerardo University Hospital, Monza, Italy. 10Department of Anaesthesia and Intensive Care, Medical Centre, Hungarian Defence Force, Budapest, Hungary. 11Interdepartmental Division of Critical Care Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 12University Health Network, Toronto, ON, Canada. 13CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh and UPMC Health System, Pittsburgh, PA. 14International Research Project Humanizing Intensive Care (Proyecto HU-CI), Intensive Care Unit, Hospital Universitario de Torrejón, Madrid. Spain. 15Department of Emergency and Critical Care Medicine, Tokai University, School of Medicine, Kanagawa, Japan. 16Department of Pulmonary and Critical Care Medicine Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 17General Hospital Novo mesto, Novo mesto, Slovenia. 18Department of Anaesthesia, Intensive Care and Acute Poisioning, Pomeranian Medical University, Szczecin, Poland. 19Aga Khan University Hospital, Nairobi, Kenya. 20Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine Vanderbilt University Medical Center, Nashville, TN. 21Siriraj Hospital, Bangkok, Thailand. 22Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China. 23Department of Intensive Care Medicine Raymond Poincaré Hospital, Paris, France. 24School of Clinical Sciences, Faculty of Medicine, Monash University & Medical Center, Melbourne, VIC, Australia. 25University New South Wales, Clinical School of Medicine, NSW, Australia. 26Department of Medicine, McGill University, Montreal, QC, Canada. 27Regroupement de Soins Critiques Respiratoires, Réseau de Santé Respiratoire FRQS, Montreal, QC, Canada. 28Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 29Krembil Neuroscience Centre, University Health Network, Toronto, ON, Canada. 30Department of Intensive Care Medicine, Brain Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, The Netherlands. 31Department of Neurocritical Care, University College London Hospitals, UCLH/UCL National Institute for Health Research Biomedical Research Centre, London, United Kingdom. 32Acute & General Medicine, Yamaguchi Graduate School of Medicine, Yamaguchi, Japan. 33Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. 34Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy.
Simone Piva
E Wesley Ely
Sheila Nainan Myatra
Jorge I F Salluh
Dawit Amare
Elie Azoulay
Giuseppe Bellelli
Akos Csomos
Eddy Fan
Nazzareno Fagoni
Timothy D Girard
Gabriel Heras La Calle
Shigeaki Inoue
Chae-Man Lim
Rafael Kaps
Katarzyna Kotfis
Younsuck Koh
David Misango
Pratik P Pandharipande
Chairat Permpikul
Cheng Cheng Tan
Dong-Xin Wang
Tarek Sharshar
Yahya Shehabi
Yoanna Skrobik
Jeffrey M Singh
Arjen Slooter
Martin Smith
Ryosuke Tsuruta
Nicola Latronico

Funding

The MIND USA StudyR01AG035117 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY · 2011 to 2016
$7.3M
Improving Long-Term Outcomes Clinical Research for Acute Respiratory FailureR24HL111895 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI NEEDHAM, DALE MURRAY · 2013 to 2017
$5.4M
Supplement to Network for Investigation of Delirium across the U.S (NIDUS)R24AG054259 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI INOUYE, SHARON K. · 2016 to 2020
$4.3M
Altering Sedation Paradigms to Improve Brain Injury and Survival in Severe SepsisR01HL111111 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PANDHARIPANDE, PRATIK · 2012 to 2017
$3.7M
The MIND ICU StudyR01AG027472 · NIA · VANDERBILT UNIVERSITY · PI ELY, E WESLEY · 2006 to 2010
$3.0M
NHLBI NIH HHS R01 HL111111NHLBI NIH HHS R24 HL111895NIA NIH HHS R01 AG027472NIA NIH HHS R01 AG035117NIA NIH HHS R24 AG054259
6 · The paper itself

Abstract

objectivesTo assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines.

designWorldwide online survey.

settingIntensive care.

interventionA cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle. MEASUREMENT AND MAIN

resultsThere were 1,521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. Spontaneous awakening trials and spontaneous breathing trials are performed in 66% and 67% of the responder ICUs, respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was "prescribed" by most, but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU-acquired weakness. Family members were actively involved in 67% of ICUs; however, only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hr/d for family visits.

conclusionsThe current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines.

Indexed as

KnowledgeAdultAgedCross-Sectional StudiesDeliriumEarly AmbulationFamilyHumansIntensive Care UnitsMedicineMiddle AgedPain ManagementPain MeasurementPatient Care BundlesPhysiciansRespiration

Identifiers

PMID28787293
PMCPMC5640479

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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.