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In 2004, the Institute for Healthcare Improvement (IHI) 100,000 lives campaign introduced the concept of a “care bundle” for the prevention of ventilator-associated pneumonia (VAP).1 A care bundle identifies a set of key interventions that, when implemented together as a best practice approach, are expected to improve patient outcomes.2 In recent years, approaches to the care of mechanically ventilated patients have evolved from fixating only on VAP prevention to focusing on a more comprehensive strategy based on the recent finding of benefit from the combined approach of the ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization)3 and the Wake Up and Breathe Collaborative trial.
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