DOI QR코드

DOI QR Code

Effects of Bed Angles and Bed Rest Time Combined with Hemostatic Methods on Discomfort and the Occurrence of Hemorrhagic Complications in Patients after Transfemoral Cerebral Angiography

뇌혈관조영술 후 침상각도와 지혈방법에 따른 침상안정 시간이 불편감과 출혈합병증에 미치는 효과

  • Kang, Young Ok (Department of Nursing, Chungnam National University Hospital) ;
  • Park, In Sook (College of Nursing, Chungnam National University)
  • Received : 2017.05.29
  • Accepted : 2017.11.08
  • Published : 2017.12.31

Abstract

Purpose: The purpose of this study was to examine the effects of bed angles and bed rest time combined with hemostatic methods on discomfort and hemorrhagic complications in patients after transfemoral cerebral angiography. Methods: Data were collected from 93 inpatients following transfemoral cerebral angiography, from April 20 to September 23, 2016. Patients were grouped according to bed angle ($0^{\circ}$ vs. $30^{\circ}$) and bed rest time combined with hemostatic methods (4-hour bed rest after manual compression vs. 2-hour bed rest after applying vascular closure device). Results: There was a significant group differences on discomfort (F=46.44, p<.001). The post-hoc analysis showed the lowest score of discomfort in those with bed angle $30^{\circ}$ and 2-hour bed rest. There was no difference in hemorrhagic complications among 4 groups. Conclusion: The postangiograpy discomfort can be effectively reduced with the least hemorrhagic complications by bed angle $30^{\circ}$ elevation and 2-hour bed rest after applying vascular closure device for those underwent transfemoral cerebral angiography.

Keywords

References

  1. Jang KH, Lee EJ. The effect of exercise therapy after cerebral endovascular surgery on the level of discomfort, low back pain, hemorrhage, and hematoma. Journal of Korean Clinical Nursing Research. 2013;19(1):69-80. https://doi.org/10.22650/JKCNR.2013.19.1.69
  2. Statistics Korea. Annual report of major cause of death [Internet]. Seoul: Author; 2015 [cited 2016 September 27]. Available from http://kosis.kr/search/search.do.
  3. Jun KS. Analysis of medical service use for cerebrovascular diseases [master's thesis]. Gimhae: Inje University; 2006. p. 1- 93.
  4. Jung SS. Clinical usefulness of magnetic resonance angiography in patient with risk factors of cerebrovascular disease [master's thesis]. Seoul: Yonsei University; 2005. p. 1-38.
  5. Kim YJ. Neurosurgery. 4th. ed. Seoul: Joongang Medical Copy; 2012. p. 71-72.
  6. Chhatriwalla AK, Amin AP, Kennedy KF, House JA, Cohen DJ, Rao SV, et al. Association between bleeding events and in-hospital mortality after percutaneous coronary intervention. Journal of American Medical Association. 2013;309(10):1022-1029. http://dx.doi.org/10.1001/jama.2013.1556
  7. Reynolds S, Waterhouse K, Miller KH. Patient care after percutaneous transluminal coronary angioplasty. Nursing Management. 2001;32(9):51-54. https://doi.org/10.1097/00006247-200101000-00022
  8. Kim PJ, Jeong JI, Ro JS, Na H, Kim KY, Kim KS, et al. The effect of position change on discomfort and bleeding after coronary angiograpy. Journal of Korean Clinical Nursing Research. 2009;15(1):19-28.
  9. Kee EJ. A study for discomfort and bleeding complications during absolute bed rest in patients undergoing percutaneous coronary intervention [master's thesis]. Suwon: Ajou University; 2001. p. 1-62.
  10. Lee EJ. A study on perceived discomfort in patients following cardiac catheterization. Journal of Korean Academy of Nursing. 1995;25(1):124-140.
  11. Khaghany K, AI-Ali F, Spigelmoyer T, Pimentel R, Wharton K. Efficacy and safety of the perclose closer S device after neurointerventional procedures: Prospective study and literature review. American Journal of Neuroradiology. 2005;26(6):1420- 1424.
  12. Nam SY, Choi-Kwon S. The effect of fowler's position change on back pain and discomfort of the patients following percutaneous coronary intervention. Perspective in Nursing Science. 2010;7(1):55-64.
  13. Vati J, Mathew TK, Sharma YP. Effect of low flowler's position on back pain and vascular complications following trans-femoral cardiac catheterization: A randomized controlled trial. i-Manager's Journal on Nursing. 2016;6(1):24-31.
  14. Jung YY, Lee CH, Her EH, Kwak IO, Back KW, Jang EM, et al. The effect of post-procedures on preventing bleeding and increasing comfort in patients received coronary angiography. Journal of Korean Clinical Nursing Research. 2002;7(2):67-84.
  15. Rolley JX, Salamonson Y, Dennison CR, Davidson PM. Nursing care practices following a percutaneous coronary intervention: Result of a survey of Australian and New Zealand cardiovascular nurses. The Journal of Cardiovascular Nursing. 2010;25(1):75-84. http://dx.doi.org/10.1097/JCN.0b013e3181bb419d
  16. Jo BU, Park YS, Seo SK, Kim JG, Lee YS. Rapid prototyping of head-of bed angle measurement system using open-source hardware. Journal of Institute of Control, Robotics and Systems. 2015;21(11):1038-1043. http://dx.doi.org/10.5302/J.ICROS.2015.15.0172
  17. Sanborn TA, Gibbs HH, Brinker JA, Knopf WD, Kosinski EJ, Roubin GS. A multicenter randomized trial comparing a percutaneous collagen hemostasis device with conventional manual compression after diagnostic angiography and angioplasty. Journal of the American College of Cardiology. 1993; 22(5):1273-1279. https://doi.org/10.1016/0735-1097(93)90529-A
  18. Jeong YN, Lee HY, Park YM. Difference of pain depending on bed rest period after lumbar puncture in patients with leukemia. Journal of East-West Nursing Research. 2008;14(1): 36-43.
  19. Carpenito LJ. Nursing Diagnosis: Application to clinical practice. Philladelphia, PA: Lippincott.Co.; 1983.
  20. Lee SY. A study of discomfort & pain of the patient following coronary angiography through femoral artery or radial artery [master's thesis]. Seoul: Kyung Hee University; 2014. p. 1-47.
  21. Cohen J. Statistical power analysis for the behavioral sciences (2nd ed.). New Jersey: Lawrence Erlbaum Associates. 1988.
  22. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. http://dx.doi.org/10.3758/BRM.41.4.1149
  23. Park AR, Choi JY. Factors predicting patient discomfort after coronary angiography. Journal of Korean Academy of Nursing. 2009;39(6):860-867. http://dx.doi.org/10.4040/jkan.2009.39.6.860
  24. Park JS, Kim ES, Park CJ. The effect of the slow stroke back massage on discomfort in patients following percutaneous transluminal coronary angioplasty. Journal of Korean Clinical Nursing Research. 2004;9(2):56-67.
  25. Kim YJ, Chung SH, Suh IS. The effect of hand massage on discomfort in patient following percutaneous coronary intervention. Journal of Korean Academy of Nursing. 2008; 20(3):452-460.
  26. Park HJ, Sohng KY. Effect of positioning on back pain and comfort of bed rest patients after transhepatic arterial chemoembolization. Journal of Korean Academy of Fundamentals of Nursing. 2005;12(3):317-324.
  27. Lee HK, Kang SY, Lee CO. The effect of exercise therapy on low back pain, self-urination disorder, bleeding, and hematoma in percutaneous coronary intervention patients. Journal of Korean Clinical Nursing Research. 2011;17(1):35-45.
  28. Ko EJ, Chae YR, Lee DS. Effects of exercise on relief of low back pain in patients on absolute bed rest after trans-arterial chemoembolization (TAE). Journal of Korean Academy of Fundamentals of Nursing. 2008;15(2):171-177.
  29. Chair SY, Taylor-Piliae RE, Lam G, Chan S. Effect of positioning on back pain after coronary angioplasty. Journal of Advanced Nursing. 2003;42(5):470-478. https://doi.org/10.1046/j.1365-2648.2003.02646.x
  30. Olson NC. Comparison of head elevation protocols following femoral artery sheath removal after coronary angiography. Critical Care Nurse. 2016;36(3):20-34. http://dx.doi.org/10.4037/ccn2016560