Articles: function.
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In cystic fibrosis, a new era has started with the approval and use of highly effective cystic fibrosis transport regulator (CFTR) modulator therapy. As pulmonary function is increasing and exacerbation rate significantly decreases, the current meaning of fungal pulmonary diseases is questioned. During the past couple of decades, several studies have been conducted regarding fungal colonization and infection of the airways in people with cystic fibrosis. ⋯ Whether the percentage will decrease or not will be the task of future evaluations in studies and registry analysis. Using the established definition for different categories of fungal diseases is recommended and should be taken into account if patients are deteriorating without responding to antibiotic treatment. Drug-drug interactions, in particular when using azoles, should be recognized and therapies need to be adjusted accordingly.
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Critical care nurse · Apr 2023
Implementing a Unit-Based Alarm Management Bundle for Critical Care Nurses.
Clinical alarms are designed to signal an unsatisfactory patient physiological state and alert staff members to malfunctioning medical equipment. Alarm desensitization and fatigue can occur when clinicians are exposed to an overwhelming number of clinical alarms, particularly nonactionable alarms. ⋯ The Joint Commission's 2022 goal of improving clinical alarm safety remains a top priority nationwide. Implementation of the CEASE alarm management bundle was effective in reducing surgical intensive care unit nurses' alarm fatigue and improving their alarm management practices.
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Semin Respir Crit Care Med · Apr 2023
ReviewMicrobial Epidemiology of the Cystic Fibrosis Airways: Past, Present, and Future.
Progressive obstructive lung disease secondary to chronic airway infection, coupled with impaired host immunity, is the leading cause of morbidity and mortality in cystic fibrosis (CF). Classical pathogens found in the airways of persons with CF (pwCF) include Pseudomonas aeruginosa, Staphylococcus aureus, the Burkholderia cepacia complex, Achromobacter species, and Haemophilus influenzae. While traditional respiratory-tract surveillance culturing has focused on this limited range of pathogens, the use of both comprehensive culture and culture-independent molecular approaches have demonstrated complex highly personalized microbial communities. ⋯ Recently, CF transmembrane conductance regulator (CFTR) modulators, small molecules designed to potentiate or restore diminished protein levels/function, have been successfully developed and have profoundly influenced disease course. Despite the multitude of clinical benefits, structural lung damage and consequent chronic airway infection persist in pwCF. In this article, we review the microbial epidemiology of pwCF, focus on our evolving understanding of these infections in the era of modulators, and identify future challenges in infection surveillance and clinical management.