Comparison of comfort and local complications after cardiac catheterization

The purpose of this study was to compare the effects of 4 hours of bed rest versus 6 hours of bed rest on patients' safety, comfort, and satisfaction levels. Using a quasi-experimental design, the authors studied 118 left-heart catheterization patients who were randomly assigned to 4 hours or 6 hours of bed rest. Among the study participants, only 1 in the 6-hour group had significant bleeding. There were no complications in the 4-hour group. There were no statistically significant differences between the two groups on any of the other study variables. Given the lack of significant complications for the 4-hour group and similar comfort levels for both study groups, these findings suggest the feasibility of reducing the standard period of postcatheterization bed rest from 6 hours to 4 hours, thereby possibly lowering the cost of the outpatient procedure.     

心导管术后经皮血管缝合装置的临床研究

目的比较心导管术拔鞘管后,采用经皮血管缝合器(Perclse)止血与人工压迫止血的效果。方法1182例患者在心导管术后,分为血管缝合组(共588例,其中冠状动脉造影290例,介入治疗298例)和手法压迫组(共594例,其中冠状动脉造影300例,冠状动脉介入术294例),分别应用Perclose止血和手法压迫止血,观察止血时间、卧床时间和并发症。结果血管缝合组和手法压迫组比较,止血时间和卧床时间明显缩短,两组并发症有显著性差异,Perclose实施成功率95.30%。结论心导管术后应用经皮血管缝合器缩短了止血时间和卧床时间,减少了患者的痛苦和并发症。     

Nursing assessment of patient readiness for ambulation after cardiac catheterization.

Although nurses routinely perform activities that prevent or detect vascular complications following a cardiac catheterization, determining patient readiness for ambulation has received minimal research attention. Educating nurses to determine patient readiness for ambulation is a safe and effective way to promote patient comfort.     

Interventions in pediatric cardiac catheterization

Since its inception in 1929, cardiac catheterization has undergone many changes. In the last two decades we have seen an evolution in cardiac catheterization from a diagnostic (anatomic and physiologic) to a therapeutic modality. This article highlights some of the more common and newer interventional procedures now performed.     

Preparation for cardiac catheterization.

Cardiac catheterization is an invasive procedure often included in the medical evaluation of patients with ischemic heart disease. This article reviews one well-designed study that examines various approaches for preparing adults for a cardiac catheterization.     

嗜酸性粒细胞增多症伴皮肤损害1例

收治1例嗜酸性粒细胞增多症伴皮肤损害的男性患者,26岁,以周身皮肤脱屑、散在皮肤破溃为主要症状就诊,实验室检查提示嗜酸性粒细胞明显升高,结合骨髓穿刺、淋巴结活检结果,临床诊断为嗜酸性粒细胞增多症,给予醋酸泼尼松治疗后病情好转。     

The effect of three positioning methods on patient outcomes after cardiac catheterization

Title.  The effect of three positioning methods on patient outcomes after cardiac catheterization.
Aim.  This paper is a report of a study to investigate the effect of three positioning protocols on back pain, heart rate, blood pressure and vascular complications after cardiac catheterization.
Background.  After cardiac catheterization, bed rest is prescribed in order to minimize vascular complications, but this often leads to back pain and other complications, such as hemodynamic instability.
Methods.  A three-group quasi-experimental design was used in this study, which was conducted in 2006. A convenience sample of 105 patients was randomly assigned to either the control or the two experimental groups (A and B). The control group received routine care. Group B was treated only with modified positioning and group A with modified positioning and a pillow under their body. Back pain, heart rate, arterial blood pressure, haematoma formation and bleeding were measured at regular time intervals.
Findings.  The control group experienced higher levels of pain after 3, 6, 8 hours and the morning after catheterization. The level of pain in group B was also higher than in group A at 3 hours after the procedure. Mean heart rate and blood pressure were lower in the experimental groups compared with the control group at 6 and 8 hours after catheterization. No statistically significant difference between the three groups regarding the amounts of overall bleeding and overall haematoma formation was observed.
Conclusion.  Changing position in bed and using a supportive pillow during the early hours after cardiac catheterization can effectively minimize pain and hemodynamic instability without increasing vascular complications.     

Achieving femoral artery hemostasis after cardiac catheterization: a comparison of methods.

BACKGROUND: Cardiac catheterization is a common procedure that involves the introduction of a small sheath (5F-8F) into the femoral artery for insertion of other diagnostic catheters. After cardiac catheterization, local compression of the femoral artery is required to prevent bleeding and to achieve hemostasis. Traditional methods of achieving hemostasis require significant time and close supervision by medical personnel and can contribute to patients' discomfort. VasoSeal is a recently developed device that delivers absorbable collagen into the supra-arterial space to promote hemostasis. OBJECTIVES: To compare outcomes between patients receiving a collagen plug and patients in whom a traditional method of achieving hemostasis was used after diagnostic cardiac catheterization. METHODS: An outcomes tracking tool was used to analyze the medical records of 95 patients in whom a traditional method was used (traditional group) and 81 patients in whom VasoSeal was used (device group) to achieve hemostasis. Complications at the femoral access site, patients' satisfaction, and times to hemostasis, ambulation, and discharge were compared. RESULTS: Hematomas of 6-cm diameter occurred in 5.3% of the traditional group; no complications occurred in the device group. The device group also achieved hemostasis faster and had earlier ambulation (P < .001). Patients in the device group were discharged a mean of 5 hours sooner than patients in the traditional group (P < .05). No significant differences were found in patients' satisfaction. CONCLUSIONS: VasoSeal is a safe and effective method of achieving hemostasis after cardiac catheterization that can hasten time to hemostasis, ambulation, and discharge.     

Cholesterol emboli syndrome following cardiac catheterization

Cholesterol emboli syndrome should always be considered in an elderly patient with acute renal failure or cutaneous lesions following an invasive vascular procedure or surgery. Laboratory findings that suggest atheroemboli include eosinophilia, an elevated erythrocyte sedimentation rate, leukocytosis, and anemia. Diagnosis is made by biopsy of the affected organ, and treatment is supportive. Patients usually die of multisystem failure.