Heart & Lung最新文献

{"title":"Immediate and short-term outcomes of in-hospital canagliflozin initiation in acute heart failure: Results from the CANA-AHF randomized clinical trial","authors":"Rabab A. EL-Gazar ,&nbsp;Bassem Zarif ,&nbsp;Ahmed Ali Ali ,&nbsp;Mira Magdy William ,&nbsp;Maggie M. Abbassi ,&nbsp;Nirmeen A. Sabry","doi":"10.1016/j.hrtlng.2025.03.007","DOIUrl":"10.1016/j.hrtlng.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Early initiation of empagliflozin, a sodium-glucose cotransporter 2 inhibitor, in acute heart failure (AHF) patients increases urine output, reduces hospital stays, and enhances quality of life post-hospital discharge.</div></div><div><h3>Objectives</h3><div>This trial aims to investigate the effectiveness and safety of early canagliflozin initiation compared to empagliflozin in hospitalized AHF patients with volume overload.</div></div><div><h3>Methods</h3><div>This was a multicenter, prospective, open-labeled, randomized equivalence trial. AHF diabetic and non-diabetic patients were randomized within 24 h from hospital admission to either receive 100 mg canagliflozin or 10 mg empagliflozin in addition to the standardized protocol for an intravenous loop diuretic. The primary outcome was the median of daily diuresis during the hospitalization period.</div></div><div><h3>Results</h3><div>Hospitalized AHF patients were enrolled (71 patients per group). The median daily diuresis during the hospitalization period was 4200 ml in the canagliflozin group, which was statistically equivalent to empagliflozin (4117 ml) with a difference of 83 ml, which falls within the predefined equivalence margin (±10) % of the median of daily diuresis of empagliflozin; Δ = ±411.7 mL), confirming equivalence via bootstrap TSOT <em>p</em> &lt; 0.001. No difference was observed in diuretic response, dyspnea score, orthodema congestion score or length of hospital stay. The NT-proBNP level at day 30 post-discharge and the change in KCCQ-TSS from baseline to day 90 were statistically comparable between both groups, without differences in safety event incidence.</div></div><div><h3>Conclusion</h3><div>Canagliflozin could be a part of usual care for hospitalized AHF patients and an alternative to empagliflozin without safety concerns.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 65-73"},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to medication adherence in patients after PCI surgery: A mixed-methods systematic review","authors":"Yong Fang ,&nbsp;Zhili Jiang ,&nbsp;Zhihao Han ,&nbsp;Xinyue Xiang","doi":"10.1016/j.hrtlng.2025.03.008","DOIUrl":"10.1016/j.hrtlng.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Patients after Percutaneous coronary intervention (PCI) should adhere to evidence-based medications to relieve symptoms and prevent cardiovascular events. However, the factors affecting patient medication adherence remain unclear.</div></div><div><h3>Objectives</h3><div>To systematically synthesize the quantitative and qualitative evidence on the barriers and facilitators to medication adherence in patients after PCI surgery.</div></div><div><h3>Methods</h3><div>A systematic search of the literature on the barriers and facilitators to medication adherence in patients after PCI surgery was performed in English and Chinese databases, including PubMed, Embase, CINAHL, Web of Science, CNKI, Wanfang and CBM, from inception to March 1, 2023. Retrieved studies were screened based on inclusion and exclusion criteria. Two researchers independently performed data extraction and quality assessment. The analysis of the barriers and facilitators to medication adherence in patients was based on the six sub-components of the Capability, Opportunity, and Motivation model of Behavior (COM-B) model, a behavioral science framework. The systematic review was registered on PROSPERO (CRD42022338400).</div></div><div><h3>Results</h3><div>A total of 15 studies were included in the review. There were 31 factors identified that influenced medication adherence in patients after PCI surgery. Among these factors, 14 served as facilitators while 17 acted as barriers. All identified factors were subsequently mapped onto the six sub-components of the COM-B model.</div></div><div><h3>Conclusion</h3><div>Identification of the barriers and facilitators to medication adherence within the six categories of the COM-B model in patients undergoing PCI can serve as a foundation for developing intervention strategies. These strategies should target the identified factors across the COM-B model. A comprehensive approach will improve medication adherence among PCI patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 57-64"},"PeriodicalIF":2.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating equitable care in the ICU:Creating a causal inference template to assess the impact of life-sustaining interventions across racial and ethnic groups","authors":"Tristan Struja MD MSc MPH ,&nbsp;João Matos MSc ,&nbsp;Barbara Lam MD ,&nbsp;Yiren Cao ,&nbsp;Xiaoli Liu PhD ,&nbsp;Ziyue Chan ,&nbsp;Yugang Jia PhD MPH ,&nbsp;Christopher M. Sauer MD MPH PhD ,&nbsp;Helen D'Couto MD ,&nbsp;Irene Dankwa-Mullan MD MPH ,&nbsp;Leo Anthony Celi MD MS MPH ,&nbsp;Andre Kurepa Waschka PhD","doi":"10.1016/j.hrtlng.2025.03.011","DOIUrl":"10.1016/j.hrtlng.2025.03.011","url":null,"abstract":"<div><h3>Background</h3><div>Variability in the provision of intensive care unit (ICU)-interventions may lead to disparities between socially defined racial-ethnic groups.</div></div><div><h3>Objectives</h3><div>We aimed to study the use of invasive mechanical ventilation (IMV), renal replacement therapy (RRT), and vasopressor agents (VP) to identify disparities in outcomes across race-ethnicity in patients with sepsis.</div></div><div><h3>Methods</h3><div>Retrospective analysis of treatment effect with a target trial design with treatment assignment within the first 24 h in MIMIC-IV (2008–2019) using targeted maximum likelihood estimation. Of 76,943 ICU stays in MIMIC-IV, 32,971 adult stays fulfilled sepsis-3 criteria. Primary outcome was in-hospital mortality. Secondary outcomes were hospital-free days, and occurrence of nosocomial infection stratified by predicted mortality probability and self-reported race-ethnicity. Average treatment effects by treatment type and race-ethnicity, Racial-ethnic group (REG) or White group (WG), were estimated.</div></div><div><h3>Results</h3><div>Of 19,419 admissions that met inclusion criteria, median age was 68 years, 57.4 % were women, 82 % were White, and mortality was 18.2 %. There was no difference in mortality benefit associated with the administration of IMV, RRT, or VP between the REG and the WG. There was also no difference in hospital-free days or nosocomial infections. These findings are unchanged with different eligibility periods.</div></div><div><h3>Conclusion</h3><div>There were no differences in the treatment outcomes from three life-sustaining interventions in the ICU according to race-ethnicity. While there was no discernable harm from the treatments across mortality risk, on average there was also no measurable benefit. These findings highlight the need for research to better understand the risk-benefit ratio of interventions in the ICU.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 48-56"},"PeriodicalIF":2.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume OXygenation index in predicting the efficacy of early non-invasive ventilation in patients with acute hypoxic respiratory failure: A multicenter study","authors":"Xiaoyi Liu ,&nbsp;Hui Liu ,&nbsp;Lijuan Chen ,&nbsp;Jun Duan ,&nbsp;Hui Ran ,&nbsp;Lili Chen ,&nbsp;Rui Zhou ,&nbsp;Xiangde Zheng","doi":"10.1016/j.hrtlng.2025.03.010","DOIUrl":"10.1016/j.hrtlng.2025.03.010","url":null,"abstract":"<div><h3>Background</h3><div>The Volume OXygenation (VOX) index was initially designed to predict treatment failure of high-flow nasal cannula therapy. However, its predictive power for non-invasive ventilation (NIV) remains uncertain.</div></div><div><h3>Objectives</h3><div>To evaluate the predictive capability of the VOX index regarding treatment failure in patients undergoing NIV.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted in three hospitals from September 2017 to September 2021. Patients with acute hypoxic respiratory failure (AHRF) who underwent early NIV treatment were categorized into high-risk and low-risk groups based on the 2-hour NIV VOX Youden index.</div></div><div><h3>Results</h3><div>At 2 h of NIV, the area under the receiver operating characteristic curve for predicting NIV failure using the VOX index was 0.843 (95 % CI 0.805–0.882). Using a VOX value threshold of 20.45 to predict NIV failure, the sensitivity was 69.1 %, and the specificity was 94.4 %. Following NIV treatment, the low-risk group had a lower intubation rate (7.98 % vs. 77 %, <em>P</em> &lt; 0.05) and mortality rate (4.79 % vs. 17.5 %, <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In early NIV treatment for AHRF, the VOX index obtained after 2 h of NIV demonstrates a strong predictive power for NIV failure. Patients with a VOX value &gt; 20.45 have a low probability of NIV failure, suggesting that it can be used as an evaluation index to assess the efficacy of NIV.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 42-47"},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Board of Directors","authors":"","doi":"10.1016/S0147-9563(25)00050-0","DOIUrl":"10.1016/S0147-9563(25)00050-0","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Page iv"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between exposure to a mixture of dichlorophenol and parabens and lung function in adults from NHANES, 2007–2012","authors":"Xinwei Li ,&nbsp;Meiyun Nie ,&nbsp;Keke Yang,&nbsp;Xiaodong Qi,&nbsp;Ling Yang","doi":"10.1016/j.hrtlng.2025.03.006","DOIUrl":"10.1016/j.hrtlng.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have examined the effects of dichlorophenol and parabens on lung function, with most focusing on individual chemicals.</div></div><div><h3>Objectives</h3><div>This study analyzes the effects of these chemicals on single or mixed exposures on lung function in adults.</div></div><div><h3>Methods</h3><div>We utilized data from the 2007–2012 National Health and Nutrition Examination Survey (NHANES), focusing on urinary levels of dichlorophenol, parabens, and lung function measures. The generalized linear regression (GLM), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were applied to assess the impact of chemical exposure on lung function.</div></div><div><h3>Results</h3><div>A total of 2,599 adults with complete data were included in the analysis. Detection rates exceeding 75 % for 2,5-Dichlorophenol (2,5-DCP), 2,4-Dichlorophenol (2,4-DCP), methyl paraben, and propyl paraben were observed. In GLMs, 2,5-DCP was significantly negatively associated with forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), either as a continuous (FVC: β = −0.012, 95 % CI = −0.018, −0.006; FEV1: β = −0.010, 95 % CI = −0.017, −0.004) or quartile variable (FVC: β = −0.027, 95 % CI = −0.039, −0.016; FEV1: β = −0.024, 95 % CI = −0.036, −0.011). The WQS regression confirmed a negative effect of the chemical mixture on lung function, with significant associations for both FVC (β = −0.013, 95 % CI = −0.018, −0.008) and FEV1 (β = −0.013, 95 % CI = −0.017, −0.007). These results were consistent in BKMR models.</div></div><div><h3>Conclusion</h3><div>Exposure to dichlorophenol and parabens, either individually or in combination, is associated with decreased lung function in humans.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 32-41"},"PeriodicalIF":2.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of intraosseous vs intravenous vascular access during resuscitation in out-of-hospital cardiac arrest: A comprehensive systematic review and meta-analysis","authors":"Shree Rath ,&nbsp;Mohamed R. Abdelraouf ,&nbsp;Wajeeh Hassan ,&nbsp;Qasim Mehmood ,&nbsp;Muhammad Ansab ,&nbsp;Hazem Mohamed Salamah ,&nbsp;Pranjal Kumar Singh ,&nbsp;Anuraag Punukollu ,&nbsp;Hritvik Jain ,&nbsp;Raheel Ahmed","doi":"10.1016/j.hrtlng.2025.03.005","DOIUrl":"10.1016/j.hrtlng.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is a known cause of mortality worldwide, especially in Western countries. One of the various treatment strategies includes vascular access for the administration of life-saving drugs such as epinephrine and lidocaine. While intravenous (IV) access is traditionally performed, recent studies have evaluated the use of intraosseous (IO) access as an alternative.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy of IV vs IO in improvement in patient outcomes with OHCA</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across five databases to identify studies comparing IV access to IO access in patients with OHCA. Statistical analysis via the ‘meta’ package and a random effects model was used and subgrouping was performed across adjusted and unadjusted values.</div></div><div><h3>Results</h3><div>Nineteen studies were included, with a total of 239,486 patients with OHCA (IV = 154,073; IO = 85,413). The incidence of return of spontaneous circulation (ROSC) was significantly lower in the IO group than in the IV group (OR = 0.71; 95 % CI: 0.65, 0.78; <em>p</em> &lt; 0.01), which was consistent across unadjusted and adjusted values. Additionally, the IO group had lower survival rates at admission, at discharge and at 30 days. The IO group had poorer neurological outcomes (OR = 0.64; 95 % CI: 0.49, 0.84; <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Our meta-analysis revealed the superiority of intravenous vascular access over intraosseous access in adult patients suffering from OHCA. However, further randomized trials are needed to confirm these results.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 20-31"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of neutrophil–lymphocyte glycemic index in patients with pulmonary embolism","authors":"Mehmet Seyfettin Saribas ,&nbsp;Muhammet Ali Erinmez ,&nbsp;Mert Cemre Unal ,&nbsp;Tamer Colak","doi":"10.1016/j.hrtlng.2025.03.004","DOIUrl":"10.1016/j.hrtlng.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) is a life-threatening condition characterized by significant morbidity and mortality. Its pathophysiology involves inflammation and stress hyperglycemia. The neutrophil-lymphocyte glycemic index (NLGI) integrates these components to offer a novel prognostic tool.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the prognostic value of NLGI in predicting in-hospital mortality and major adverse events (MAEs) among patients diagnosed with PE.</div></div><div><h3>Methods</h3><div>A retrospective analysis included patients diagnosed with PE using computed tomography pulmonary angiography or ventilation/perfusion scans. Exclusion criteria included chronic PE, diabetes, renal/liver disease, or missing data. NLGI was calculated based on neutrophil count, lymphocyte count, and plasma glucose levels. The primary and secondary outcomes were in-hospital mortality and MAEs, respectively. Logistic regression and receiver operating characteristic (ROC) analyses were performed to assess prognostic performance.</div></div><div><h3>Results</h3><div>Among 281 patients, in-hospital mortality occurred in 10.3 %, while 17.8 % experienced MAEs. Elevated NLGI was significantly associated with higher mortality and MAEs. Logistic regression confirmed NLGI as an independent predictor of both outcomes. ROC analysis revealed that NLGI showed a higher AUC (0.854) in predicting in-hospital mortality compared to other markers.</div></div><div><h3>Conclusions</h3><div>NLGI is a robust, independent predictor of in-hospital mortality and MAEs in PE patients. Its simplicity and strong predictive capability make it a valuable tool for early risk stratification in clinical practice.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 13-19"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waist circumference and body surface area and the risk of developing new-onset atrial fibrillation: A systematic review and meta-analysis of observational studies","authors":"Shayan Shojaei ,&nbsp;Hanieh Radkhah MD ,&nbsp;Iman Akhlaghipour ,&nbsp;Arya Nasimi Shad ,&nbsp;Alireza Azarboo ,&nbsp;Asma Mousavi","doi":"10.1016/j.hrtlng.2025.02.008","DOIUrl":"10.1016/j.hrtlng.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a prevalent cardiac arrhythmia with significant health consequences. Identifying modifiable risk factors, such as obesity, is crucial. While body mass index (BMI) is linked to increased AF risk, the association between new-onset AF (NOAF) and other anthropometric measures like waist circumference (WC) and body surface area (BSA) warrants further investigation.</div></div><div><h3>Objectives</h3><div>This systematic review and meta-analysis aimed to compare mean WC and BSA between individuals who developed NOAF and those who did not.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search up to February 2024 for studies comparing mean WC and BSA in groups with and without incident NOAF. Participants had no prior AF history. We used a random-effects model to calculate standardized mean differences (SMDs) and 95 % confidence intervals (CIs). Subgroup analyses explored NOAF occurrence following coronary artery bypass graft (CABG) surgery, in the absence of any preceding procedure, and after other cardiac procedures.</div></div><div><h3>Results</h3><div>Our analysis of 34 studies revealed that adults with NOAF had significantly higher WC (SMD = 0.20, 95 % CI 0.01; 0.39) and BSA (SMD = 0.06, 95 % CI 0.01; 0.11) compared to those without NOAF. Subgroup analysis showed a more pronounced association in individuals developing NOAF after CABG (SMD = 0.33, 95 % CI 0.17; 0.48) and in those without any prior procedure before NOAF diagnosis (SMD = 0.23, 95 % CI 0.08; 0.38) versus those without NOAF.</div></div><div><h3>Conclusion</h3><div>Higher WC and BSA appear to be significantly associated with an increased risk of NOAF, with the relations being more pronounced in specific subgroups.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"72 ","pages":"Pages 1-12"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to enhance nurses' adherence to central line-associated bloodstream infection prevention bundles in the ICU setting: A systematic review","authors":"Diaa Bou Hamdan RN, MSN ,&nbsp;Sarah Hatahet RN, MSN ,&nbsp;Heba Khalil RN, PhD ,&nbsp;Khalil M. Yousef RN, PhD","doi":"10.1016/j.hrtlng.2025.02.009","DOIUrl":"10.1016/j.hrtlng.2025.02.009","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of central line-associated bloodstream infection (CLABSI) in the ICU continues to rise. Despite existing CLABSI bundles to prevent infections, adherence remains suboptimal.</div></div><div><h3>Objective</h3><div>To identify and synthesize the evidence about strategies used to enhance nurses’ adherence to CLABSI prevention bundles.</div></div><div><h3>Methods</h3><div>Five databases were searched: CINAHL, MEDLINE, PubMed, Cochrane Library, and SCOPUS. Eligible studies were those published between 2012–2024, and investigated the adherence to central line bundles and strategies to improve adherence in the ICU. Two reviewers independently screened, critically appraised, and extracted data using Joanna Briggs Institute tools. The review protocol was registered on PROSPERO (CRD42024513345).</div></div><div><h3>Results</h3><div>Seven studies met the inclusion criteria, including four quality improvement projects and three quasi-experimental studies. The studies ranged in quality from moderate to high, with scores between 68.75 %-88.88 %. These studies explored various strategies to enhance nurses' adherence to CLABSI prevention bundles. Strategies included education, leadership, and auditing/feedback mechanisms. Education was the primary strategy utilized and included simulation and online training. Active participation in decision making, transparency in sharing CLABSI outcome data, celebrating achievements, and electronic documentation were essential aspects of leadership support to promote adherence. Implementing these strategies led to significant improvements in nurses’ adherence to bundle (&lt;0.01).</div></div><div><h3>Conclusion</h3><div>Education, leadership, and audit mechanisms improve adherence to CLABSI bundles. Yet, the current evidence lacks randomized controlled trails that can establish effectiveness of these strategies. Future research should also investigate the long-term effect of these strategies on adherence, and the influence of organizational culture on CLABSI bundle adherence.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 98-105"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}