- 作者：Mina Mohammady ; Kazem Heidari ; Ali Akbari Sari ; Mitra Zolfaghari ; Leila Janani
- 关键词：Catheterisation ; Bed rest ; Femoral artery ; Coronary angiography ; Early ambulation
- 刊名：International Journal of Nursing Studies
- 出版年：January, 2014
- 年：2014
- 卷：51
- 期：1
- 页码：39-50
- 全文大小：1153 K
Background
Femoral arterial puncture is the most common method of vascular access for angiography. Because of possible vascular events, all patients are restricted to strict immobilisation and bed rest for 2-24 h, which is accompanied by back pain and discomfort.Objective
To assess the effects of the duration of bed rest after transfemoral catheterisation on the prevention of vascular complications and general discomfort, pain, urinary discomfort and patient satisfaction.
Data sources
We searched the Cochrane Library, MEDLINE, SCOPUS, CINAHL, Proquest Dissertations, Open SIGLE, Iranmedex and Irandoc.
Study selection
We included blinded or unblinded randomised controlled trials and quasi-randomised controlled trials that used two different durations of bed rest after angiography before the ambulation was permitted.
Data extraction and analysis
Two reviewers separately assessed the quality of each study and extracted the data. We present dichotomous outcomes as odds ratios with 95% confidence intervals (CI) and continuous outcomes as mean differences with 95% CI.
Data synthesis
Twenty studies involving a total of 4019 participants with a mean age of 59.5 years were included. The studies considered periods of bed rest ranging from 2 to 24 h, which we compared in three main categories. There were no statistically significant differences between categories in the incidence of bleeding, haematoma, bruising, pseudoaneurysm, thrombus or arteriovenous fistula. Back pain intensity was assessed in four studies. Patients had significantly less back pain after 2-4 h bed rest compared to 6 h bed rest at 2 h (mean difference: 鈭?.70, 95% CI: 鈭?.07, 鈭?.32), 4 h (mean difference: 鈭?.60, 95% CI: 鈭?.96, 鈭?.24) and 6 h of follow-up (mean difference: 鈭?.77, 95% CI: 鈭?.48, 鈭?.92). One study that assessed urinary discomfort reported less urinary discomfort when bed rest lasted 4 h compared to 12-24 h (mean difference: 鈭?.48; 95% CI: 鈭?.37, 鈭?.59). In addition, reduced bed rest time may significantly decrease the costs of hospital care.
Conclusions
This systematic review suggests that patients can be ambulated after 2-3 h following transfemoral catheterisation, and that early ambulation had no significant effect on the incidence of vascular complications and may reduce back pain and urinary discomfort.