The ICU Liberation Bundle and Strategies for Implementation in Pediatrics

• Published in: Current pediatrics reports (Philadelphia, PA) Vol. 8; no. 3; pp. 69 - 78
• Main Authors: Walz, Alice, Canter, Marguerite Orsi, Betters, Kristina
• Format: Journal Article
• Language: English
• Published: New York Springer US 2020
• Subjects: Critical Care (J Giuliano and E Mack; Critical Care (J Giuliano and E Mack, Section Editors); Medicine; Medicine & Public Health; Pediatrics; Section Editors; Topical Collection on Critical Care; Delirium; Post-intensive care syndrome; Pediatric critical care; Sedation
• ISSN: 2167-4841; 2167-4841
• DOI: 10.1007/s40124-020-00216-7

Purpose of Review We briefly review post-intensive care syndrome (PICS) and the morbidities associated with critical illness that led to the intensive care unit (ICU) liberation movement. We review each element of the ICU liberation bundle, including pediatric support data, as well as tips and strategies for implementation in a pediatric ICU (PICU) setting. Recent Findings Numerous studies have found children have cognitive, physical, and psychiatric deficits after a PICU stay. The effects of the full ICU liberation bundle in children have not been published, but in adults, bundle implementation (even partial) resulted in significant improvement in survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge disposition. Summary Although initially described in adults, children also suffer from PICS. The ICU liberation bundle is feasible in children and may ameliorate the effects of a PICU stay. Further studies are needed to characterize the benefits of the ICU liberation bundle in children.