Bed rest for preventing complications after transfemoral cardiac catheterisation: a protocol of systematic review and network meta-analysis

Abstract

BackgroundTransfemoral cardiac catheterisation is an invasive medical procedure used for therapeutic or diagnostic purposes. Postoperative bed rest can prevent a number of complications such as bleeding and haematoma formation and can result in side effects such as back pain and urinary discomfort. Currently, there is no consensus regarding the optimal length of bed rest. Our objective is to assess the effects of post-catheterisation length of bed rest on bleeding and haematoma, other vascular complications, patient symptoms and patient discomfort, among patients who underwent transfemoral cardiac catheterisation.MethodsWe wrote this protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. We defined the search query by using the PICO framework (Population: Patients undergoing cardiac catheterisation; Intervention: early mobilisation; Comparison: late mobilisation; Outcomes: early and late complications). We will search six biomedical databases and five online registries to obtain both published and unpublished studies. We will include randomised controlled trials and quasi-randomised controlled trials, and their quality will be independently appraised with the Cochrane Effective Practice and Organisation of Care criteria for quality assessment. We will carry out a pairwise meta-analysis and network meta-analysis to estimate the overall intervention effects from both direct and indirect comparisons.DiscussionThis review may have considerable implications for practice and help to achieve an effective and efficient management of patients who underwent cardiac catheterisation. This review will be grounded in an expanded search of 11 resources and will employ innovative statistical methods such as network meta-analysis.Systematic review registrationPROSPERO registration number: CRD42014014222.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0036-0) contains supplementary material, which is available to authorized users.

Radial Access for Coronary Angiography Carries Fewer Complications Compared with Femoral Access: A Meta-Analysis of Randomized Controlled Trials

“…The transfemoral approach for CA and PCI gained widespread acceptance by operators because of the following advantages: long history of use, easy technicality, and the ability of clinicians to use larger catheters and equipment for various interventions [ 50 ]. However, the femoral catheterization approach has some disadvantages, including the need for patients’ prolonged bed rest, which could be associated with back pain, urinary retention, and neuropathy, particularly in the elderly [ 6 , 51 , 52 ],as well as prolonged arterial compression related complications, e.g., peripheral ischemia. These limitations promptedcardiologists to explore attempting the trans-radial approach as an alternative, with the first procedure performed in 1989 by Campeau [ 6 ], which demonstrated excellent results.…”

A novel wireless implant for central venous pressure measurement: First animal experience

“…EJ access is associated with a low rate of severe mechanical complications compared to femoral access. 27 , 28 Although the EJ/bijugular trunk junction was used opportunistically in this study, it is believed that other acceptable junctions exist in the ovine and human venous systems, requiring little or no modification of the existing angular interference anchors.…”

Safety and Feasibility of Transradial Access in Patients Presenting With Traumatic Injuries: A Single Urban Center Experience

“…In these cases, femoral access may not be optimal to obtain due to the access site proximity to the trauma or the need for leg immobility after a TFA which delays further interventions such as surgery. 2,19 At a level 1 trauma center with a high volume of high-speed motor vehicle injuries, TRA may in fact provide easier access and therefore may improve procedure time/patient morbidity. In tall patients, certain traumatic interventions may not be currently possible using a TRA due to this limitation.…”