Abstract
Contemporary cardiac intensive care units (CICUs) have an increasing prevalence of noncardiovascular comorbidities and multisystem organ dysfunction. However, little guidance exists to support the development of best-practice principles specific to the CICU. This scientific statement evaluates strategies to avoid the potentially preventable complications encountered within contemporary CICUs, focusing on those that are most applicable to the CICU environment. This scientific statement reviews evidence-based practices derived in non-CICU populations, assesses their relevance to CICU practice, and highlights key knowledge gaps warranting further investigation to attenuate patient risk.
Highlights
Contemporary cardiac intensive care units (CICUs) have an increasing prevalence of noncardiovascular comorbidities and multisystem organ dysfunction
We review evidence-based practices derived in relevant critical care populations, assess their relevance to CICU practice, and highlight key knowledge gaps warranting further investigation to attenuate patient risk
We suggest that all CICUs use best-practice care bundles to prevent common health care–associated infections (HAIs), including central line–associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) (Tables 1–3)
Summary
Difficile, and MDR Gram-negative rods, are increasingly common among hospitalized patients.[10,15,44] few specific data exist, patients in the CICU are considered at risk of colonization and infection by MDR pathogens because of healthcare exposure and the frequent use of antibiotics, CVCs, and MV. Use of gown-and-glove contact precaution strategies has not been consistently effective for preventing the transmission of MDR pathogens in clinical trials, potentially because of inadequate rates of provider compliance or low prevalence of MDR pathogens outside of outbreak conditions.[10,15] this strategy is reasonable given its simplicity and limited risk. Recommended practices to prevent the spread of MDR pathogens[10,15] include the following: 1. Meticulous hand hygiene, preferably with alcohol-based hand sanitizer
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