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Review
. 2020;8(3):69-78.
doi: 10.1007/s40124-020-00216-7. Epub 2020 May 16.

The ICU Liberation Bundle and Strategies for Implementation in Pediatrics

Alice Walz  1 , Marguerite Orsi Canter  2 , Kristina Betters  3
Affiliations
Review

The ICU Liberation Bundle and Strategies for Implementation in Pediatrics

Alice Walz et al. Curr Pediatr Rep. 2020.

Abstract

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.

Keywords: Delirium; Pediatric critical care; Post-intensive care syndrome; Sedation.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Overlap of behavioral cues in pain, sedation, withdrawal syndrome, and delirium. Reprinted from Julia Harris et al., Intensive Care Medicine 2016
See this image and copyright information in PMC

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