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The American Heart Association has just released a scientific statement “Prevention of Complications in the Cardiac Intensive Care Unit” (Fordyce 2020). The suggested practices for cardiac intensive care units (CICU’s) are based primarily on evidence generated from patients admitted to general medical or surgical ICU’s but take into account the special circumstances and underlying conditions that CICU patients have. They recognize there has been “substantial heterogeneity in care of critically ill cardiac patients” and note that this document aims to provide standardized approaches to preventive care using the best available evidence. It suggests the use of a bedside checklist to inform best practices in the prevention of complications in this unique population.
Details of the topics in this comprehensive 28-page document are beyond the scope of today’s column. The topics are arranged under the following categories:
PREVENTION OF CICU-ACQUIRED INFECTIONS
APPROACH TO ANALGESIA AND SEDATION AND THE DIAGNOSIS AND PREVENTION OF DELIRIUM
PREVENTION OF VENTILATOR COMPLICATIONS
BENEFITS OF EARLY MOBILIZATION
PREVENTION OF GASTROINTESTINAL COMPLICATIONS
PREVENTION AND RECOGNITION OF MEDICATION COMPLICATIONS AND ERRORS
COMPLICATIONS OF INVASIVE CARDIAC PROCEDURES AND DEVICES
TRANSITIONS OF CARE BEST PRACTICES
The document also provides a sample “Daily Bedside Checklist” to encourage best practices and to prevent complications for patients admitted to the cardiac intensive care unit (CICU). It has reminders sorted into the major categories noted above.
This is a very useful and timely document and comes with 150 references. We hope you’ll read the details of each topic and implement their suggested best practices.
Fordyce CB, Katz JN, Alviar CL, et al. Prevention of Complications in the Cardiac Intensive Care Unit: A Scientific Statement From the American Heart Association. Circulation 2020; Published online 29 October 2020
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