What is the Role of the ABCDEF Bundle in Patients on Extracorporeal Membrane Oxygenation?

  • Mina F. Nordness
  • Mayur B. PatelEmail author
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)


The ABCDEF bundle (i.e., Assess, Prevent and Manage Pain; Both Spontaneous Awakening/Breathing Trials; Choice of analgesia and sedation; Delirium: Assess, Prevent, Manage; Early Mobility; Family engagement) is a popular topic in critical care and cardiac surgery. There are several special considerations depending on the patient population prior to embarking on these efforts. Patients requiring circulatory support for either respiratory and/or cardiac dysfunction via extracorporeal membrane oxygenation (ECMO) may have pulmonary and/or hemodynamic instability. This severity of illness may elevate uncertainty about the implementation of the ABCDEF bundle in ECMO patients, and herein lays the current evidence about using these elements in patients with severe cardiopulmonary dysfunction requiring this advanced life support.


ABCDEF bundle Awakening trials Breathing trials Delirium ECMO Extracorporeal membrane oxygenation Early mobility Extubation Family engagement Pain Sedation 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Vanderbilt University Medical Center, Section of Surgical Sciences, Department of Surgery, Division of Trauma, Emergency General Surgery, and Surgical Critical CareNashvilleUSA
  2. 2.Vanderbilt Center for Health Services ResearchVanderbilt Brain Institute, Vanderbilt ICU Delirium & Cognitive Impairment Study GroupNashvilleUSA
  3. 3.Vanderbilt University Medical Center, Departments of Neurosurgery and Hearing & Speech SciencesNashvilleUSA
  4. 4.Surgical Services, Geriatric Research, Education and Clinical Center, Nashville VA Medical Center, Tennessee Valley Healthcare System, US Department of Veterans AffairsNashvilleUSA

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