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Bed rest duration after sheath removal following percutaneous coronary interventions: a systematic review and meta‐analysis

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  • Mina Mohammady
  • Fatemeh Atoof
  • Ali Akbari Sari
  • Mitra Zolfaghari

Abstract

Aims and objectives To explore the effect of bed rest duration after sheath removal following percutaneous coronary interventions on the incidence of vascular complications, back pain and urinary problems. Background According to the literature, the duration of bed rest after sheath removal following percutaneous coronary interventions ranges from 2–24 hours. Several studies have assessed the effect of duration of bed rest on vascular complications, but a clear final conclusion about the exact duration of bed rest has not been reached. Design Systematic review and meta‐analysis. Methods Cochrane Library, MEDLINE, SCOPUS, CINAHL, IranMedex and IranDoc were searched. No language limitation was applied. RCTs that used two different periods for ambulation were included. Two reviewers separately assessed the quality of each included study and extracted the data. Dichotomous outcomes were recorded as odds ratio with 95% confidence interval. Results Five studies involving 1115 participants were included in the review. Among them, two studies had three comparison groups. The studies considered a variety of periods as early and late ambulation, ranging from 2–10 hours. Totally, there were no statistically significant differences in the incidence of bleeding, pseudoaneurysm, arteriovenous fistula and urinary problems between early and late ambulation. There was a statistically significant reduction in the risk of haematoma formation at four to six hours of bed rest compared with eight hours of bed rest (odds ratio = 0·37, 95% CI: 0·15, 0·91). Back pain was reported in one study evaluating three hours of bed rest with an odds ratio of 0·45 (95% confidence interval: 0·28, 0·71) when compared with 10 hours of bed rest. Conclusions Early ambulation after percutaneous coronary interventions is safe and feasible; however, the results should be used with caution as the majority of included studies had methodological flaws. Relevance to clinical practice The results of this study suggest that patients could be ambulated three to four hours after sheath removal following percutaneous coronary interventions and early ambulation dose does not increase the risk of vascular complications, but it moderates back pain occurrence.

Suggested Citation

  • Mina Mohammady & Fatemeh Atoof & Ali Akbari Sari & Mitra Zolfaghari, 2014. "Bed rest duration after sheath removal following percutaneous coronary interventions: a systematic review and meta‐analysis," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(11-12), pages 1476-1485, June.
    • Handle: RePEc:wly:jocnur:v:23:y:2014:i:11-12:p:1476-1485
    DOI: 10.1111/jocn.12313
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Selda Mert Boğa & Seher Deniz Öztekin, 2019. "The effect of position change on vital signs, back pain and vascular complications following percutaneous coronary intervention," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(7-8), pages 1135-1147, April.
    2. Vinicius Batista Santos & Luize Máximo e Melo & Ana Raquel Viegas de Assis & Juliana Brito de Moraes & Camila Takao Lopes & Juliana de Lima Lopes & Alba Lucia Bottura Leite de Barros, 2019. "Decreasing length of limb immobilisation following nonelective transfemoral percutaneous coronary intervention: A randomised clinical trial," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(17-18), pages 3140-3148, September.

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