Vîrtosu Daniela-Mirela, Munteanu Dragomir Angela, Crișan Simina, Luca Silvia, Pătru Oana, Băghină Ruxandra-Maria, Lazăr Mihai-Andrei, Cozlac Alina-Ramona, Iurciuc Stela, Luca Constantin-Tudor
Doctoral School, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania.
J Clin Med. 2025 Jul 12;14(14):4941. doi: 10.3390/jcm14144941.
This review aims to summarize the global prevalence of healthcare-associated infections in patients with acute heart failure who have been admitted to coronary care units, highlighting the underrepresented burden of infection in this high-risk population. Coronary care units (CCUs) play a pivotal role in the care of patients experiencing acute or decompensated heart failure, offering a highly monitored environment with immediate access to advanced cardiac interventions. The management of heart failure in CCUs involves a multidisciplinary approach that includes hemodynamic monitoring, pharmacologic therapy, respiratory support, and, in selected cases, mechanical circulatory assistance. The early identification of deterioration, rapid therapeutic escalation, and close monitoring of cardiac function are hallmarks of CCU care. However, the complexity and severity of illness in this population are compounded by a high risk of infections, including hospital-acquired pneumonia, bloodstream infections, and device-related infections. These infections not only increase morbidity and prolong hospitalization but also significantly impact mortality and healthcare costs. The immunocompromised state of many heart failure patients-due to poor perfusion, malnutrition, and the use of invasive devices-further elevates their vulnerability. Effective infection prevention, early diagnosis, and targeted antimicrobial therapy are, therefore, critical components of heart failure management within CCUs. This intersection of advanced cardiac care and infection control highlights the need for integrated, multidisciplinary strategies to improve outcomes in this high-risk population.
本综述旨在总结入住冠心病监护病房的急性心力衰竭患者中医疗相关感染的全球患病率,强调这一高危人群中未得到充分重视的感染负担。冠心病监护病房(CCU)在急性或失代偿性心力衰竭患者的护理中起着关键作用,提供高度监测的环境,可立即获得先进的心脏干预措施。CCU中心力衰竭的管理涉及多学科方法,包括血流动力学监测、药物治疗、呼吸支持,以及在特定情况下的机械循环辅助。早期识别病情恶化、迅速升级治疗以及密切监测心脏功能是CCU护理的标志。然而,该人群疾病的复杂性和严重性因感染风险高而加剧,包括医院获得性肺炎、血流感染和与器械相关的感染。这些感染不仅增加发病率、延长住院时间,还会显著影响死亡率和医疗成本。许多心力衰竭患者由于灌注不良、营养不良和使用侵入性器械而处于免疫功能低下状态,这进一步增加了他们的易感性。因此,有效的感染预防、早期诊断和针对性抗菌治疗是CCU中心力衰竭管理的关键组成部分。先进的心脏护理与感染控制的这种交叉突出了采取综合、多学科策略以改善这一高危人群预后的必要性。