Xiao-Li Ren, Jian-Hua Li, Chong Peng, Hong Chen, Hai-Xia Wang, Xue-Ling Wei, Qing-Hong Cheng
Department of Critical Care Medicine, 1st Affiliated Hospital of Medical College, Shihezi University, Shihezi, Xinjiang, China (mainland)
Med Sci Monit 2017; 23:4650-4656
Mechanical ventilation is an important part of advanced life support in the intensive care unit (ICU). This study aimed to investigate the effects of ABCDE bundle on hemodynamics in patients on mechanical ventilation (MV).
MATERIAL AND METHODS: This study used a cross-sectional overall controlled approach in which 143 patients on mechanical ventilation were divided into 2 groups. In the pre-ABCDE bundle group (n=70), conventional sedation and analgesia strategy were used. In the post-ABCDE bundle group (n=73), ABCDE bundle was used. Changes in hemodynamics parameters and related prognostic indicators were monitored at various time points before (T0) and at 1 d (T1), 3 d (T3), 5 d (T5), and 7 d (T7) after implementation of the 2 strategies.
RESULTS: Mean arterial blood pressure (MAP), central venous pressure (CVP), heart rate (HR), and oxygenation index (PaO2/FiO2) in the bundle group were improved more significantly than those in the pre-ABCDE bundle group (P<0.05). For comparison between various monitoring time points in the same group, compared with before intervention, MAP, CVP, HR, and PaO2/FiO2 changed significantly in the bundle group at 3 d, 5 d, and 7 d after intervention, and the difference was statistically significant (P<0.05). Compared with before intervention, differences in all hemodynamics indicators were statistically significant in the pre-ABCDE bundle group at 5 d and 7 d after intervention (P<0.05). Compared with the pre-ABCDE bundle group, differences in prognostic indicators in the post-ABCDE bundle were statistically significant (P<0.05).
CONCLUSIONS: ABCDE bundle is safe and effective for patients on mechanical ventilation, and can improve hemodynamics and enhance oxygenation index. ABCDE bundle might be helpful in reducing 28-d mortality and improving prognosis.
Keywords: mechanical ventilation, Hemodynamics, ABCED Bundle, Oxygenation Index