To evaluate clinical outcomes after implementation of the ABCDEF bundle in neurocritical patients.

Patients in ICUs frequently face long-term physical, mental, and cognitive impairments. The ABCDEF bundle offers an evidence-based framework to enhance outcomes by addressing pain, sedation, delirium, early mobility, and family involvement. Its implementation has been shown to improve clinical outcomes, reducing ICU stay, mortality, and mechanical ventilation duration.

A two-year prospective study (March 2022–March 2024) in a clinical-surgical ICU compared 32 patients treated with the ABCDEF bundle to receiving standard care. Categorical variables were reported as frequencies, and quantitative data as means or standard deviations based on normality (Shapiro-Wilk test). Group comparisons used Student’s t-test or Mann-Whitney U, with linear regression analyzing outcomes for hospital stay and ventilation days (p < 0.05).

Of the patients, 53.3% were male, with a mean age of 48.9 ± 18 years. The 30% of neurocritical pathologies included intraparenchymal hemorrhages, traumatic brain injuries, and convulsive status. The implementation of the ABCDEF package led to a reduction in mechanical ventilation days by 3.79 days (p < 0.001) and ICU stay by 2.52 days (p = 0.012). Mortality was significantly lower in the group that received the protocol, at 6.9%, compared to 36.2% in the group that did not (p < 0.001).

The ABCDEF protocol in ICU patients significantly reduces the days of mechanical ventilation and length of hospital stay, leading to decreased morbidity and mortality. This, in turn, translates into lower healthcare costs and improved clinical outcomes for patients.