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Malekzadeh J, Ghouchani M, Sadeghi T, Bagherimoghadam A, Rajabpour M. The Effects of the ABCDE Bundle on the Hemodynamic Stability of Patients under Mechanical Ventilation. JHNM 2025; 35 (3) :228-238
URL: http://hnmj.gums.ac.ir/article-1-2254-en.html

Introduction: The number of adult patients requiring mechanical ventilation in Intensive Care Units (ICUs) is increasing every year. It is necessary to identify effective solutions to hemodynamic problems of mechanical ventilation.
Objective: The present study was designed to determine the effect of the ABCDE bundle (ABC: Awakening, Breathing, and Coordination, D: Delirium, Monitoring, E: Early Mobility) on the hemodynamic stability of patients under mechanical ventilation.
Materials and Methods: The study is a two-group clinical trial. The research sample included 90 patients undergoing mechanical ventilation in an ICU, who were randomly assigned to the intervention and control groups by the block randomization method. The most important inclusion criteria were as follows: Being 18-60 years old; suffering from subgroups of pulmonary diseases; and having a minimum duration of mechanical ventilation of 48 hours. The exclusion criterion was unwillingness to continue participation in research at any stage. In the intervention group, the ABCDE bundle was implemented in 7 days. Hemodynamic indicators, including Mean Arterial Pressure (MAP), Pulse Pressure (PP), and Heart Rate (HR), were measured on days 0, 1, 3, 5, and 7. In the control group, common sedation and pain relief were performed according to the routine of the ward. Repeated Measures Analysis of Variance (ANOVA), independent t-test, chi-square test, and Mann-Whitney test were used for data analysis. P<0.05 were considered statistically significant.
Results: Patients’ Mean±SD ages were 48.76±11.46 in the intervention group and 47.58±11.56 years in the control group. In the ABCDE bundle group, MAP was stable on day 7 compared with day 0, but there was a statistically significant decrease in MAP in the control group (P<0.05). Also, in the intervention group, the PP increased and the HR decreased significantly (P=0.001). The results of the repeated measures ANOVA showed that the effects of time, group, and the interaction effect of time and group on the mean MAP and PP were significant (P=0.001). Additionally, only the effect of group on the mean HR was significant (P=0.038).
Conclusion: It seems that the ABCDE bundle can improve hemodynamic indicators and be performed as an effective and accessible method by nurses.