TYPE: Abstract
TOPIC: Critical Care
PURPOSE: The purpose of this study was to assess what effect the COVID-19 pandemic has had on intensivists' adherence to the ICU liberation (ABCDEF) bundle.
METHODS: We sent a web-based, anonymous, voluntary survey to practicing ICU faculty and fellows in Critical Care and Pulmonary/Critical Care Medicine fellowship training programs in the United States. Participants were asked to compare their sedation practices in COVID-19 and non- COVID-19 patients. Answers were collected on a 5-point Likert scale. Survey questions asked about sedation practices, use of common ICU drugs, and the ABCDEF ICU liberation bundle.
RESULTS: Of 68 survey respondents, 72.1% were male, 27.9% female. 51.5% were attending physicians, and 48.5% fellows in critical care. 54.4% practiced in the West South Central region of the United States. 63.2% used a deeper sedation target for COVID-19 patients. 48.5% performed spontaneous awakening and spontaneous breathing trials less frequently in COVID-19 patients. Benzodiazepines were used more frequently by 64.7% of survey participants (35.3% no change), opiates by 47.1% (52.9% no change); propofol by 36.8% (52.9% no change); dexmedetomidine by 36.8% (52.9% no change); ketamine by 47.1% (50.0% no change). 41.2% reported an increased use of antipsychotic agents (57.4% no change). 75.0% of respondents used more paralytic bolus dosing; 85.3% more continuous infusions of paralytics. 63% screen for delirium with validated delirium screening tools; 13% do not routinely screen for delirium. 58.8% were unable to provide early mobilization to their COVID-19 patients.
CONCLUSIONS: The COVID-19 pandemic has reduced compliance with the ICU liberation bundle.
CLINICAL IMPLICATIONS: Renewed efforts to ensure adherence to the ICU liberation bundle are needed.
DISCLOSURE: Nothing to declare.
KEYWORD: ABCDEF bundle