The Science, Why, and What of ICU Liberation and the ABCDEF Bundle for Patients and FamiliesDr. Wes Ely Hawaii SCCM 2017 PlenaryHAWAII PLENARY on ICU LIBERATION ABCDEF and PICS before over 2,000 people January 2017: Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called post-intensive care syndrome (PICS). PICS patients are suffering from impairments in these domains of life: cognitive (impaired executive functioning), emotional (depression, anxiety, post-traumatic stress disorder), and physical (weakness, myopathy, and neuropathy). They cannot resume their previous life including ADLs and IADLs. The ICU Liberation Collaborative was a real-world quality improvement initiative implemented across 76 ICUs designed to engage strategically the ABCDEF bundle from 2015-17 ( A – Assess, Prevent and Manage Pain, B – Both spontaneous awakening trials and spontaneous breathing trials, C – Choice of Sedation, D – Delirium: Assess, Prevent and Manage, E – Early Mobility and Exercise, and F – Family Engagement and Empowerment) through team and evidence-based care.