AHA releases guidance for Best Practices in Cardiac ICU

The checklist includes strategies to optimize care and prevent complications related to:

• infections;
• pain management;
• ventilator complications;
• lack of mobilization (early mobilization is recommended for the majority of patients);
• gastrointestinal complications and proper nutrition;
• medication use and errors;
• device use; and
• inclusion of the appropriate specialists for multidisciplinary care.

• Hand hygiene to prevent hospital-acquired infections
• Adhering to safe mechanical ventilation parameters to prevent ventilator complications (e.g., keeping tidal volume at 6-10 mL/kg ideal body weight for most patients and tailoring applied positive end-expiratory pressure to each patient's underlying pathophysiological condition)
• Early mobilization for most patients (except those with active ischemia or infarction) to prevent muscle weakness.Mobilization protocols can help improve physical functioning, decrease time on a ventilator and shorten a hospital stay.
• Early initiation of enteral nutrition in most people who are unable to eat and providing stress ulcer prophylaxis for those at increased risk of gastrointestinal bleeding
• Routine screening for delirium and minimizing the use of benzodiazepines and other medications associated with delirium
• Invasive diagnostic and therapeutic procedures should be anticipated and performed before they become emergency, and any invasive catheter or mechanical circulatory support device removed promptly when no longer needed.