Effects of three groin compression methods on patient discomfort, distress, and vascular complications following a percutaneous coronary intervention procedure

Linda Chlan, Julie Sabo, Kay Savik

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Background: Incidence of vascular complications (VCs) after sheath removal following a percutaneous coronary intervention procedure (PCIP) vary widely by the compression method used to achieve femoral artery hemostasis. Objective: To determine if one groin compression method causes the least discomfort and distress for patients and results in fewer VCs. Methods: Patients (n ≤ 306, mean age ≤ 62.3 years, 77% male, 96.4% Caucasian) undergoing PCIPs at a tertiary care center in the urban Midwest participated in this three-group experimental design study. They were randomly assigned to Femostop®, C-clamp, or manual compression and rated level of groin discomfort and distress on a 0-10 Numeric Rating Scale (NRS) prior to, during, and after arterial compression was released. The groin area was assessed for any VCs (oozing, ecchymosis, hematoma) prior to sheath removal, after compression released, and 12 and 24 hr after sheath removal. Results: No significant differences were found by compression method for discomfort, distress, or VCs. Regardless of method, not having a VC prior to femoral sheath removal contributes to less oozing (z ≤ ĝ̂'3.1, p ≤ .0019), hematoma (z ≤ ĝ̂'9.4, p < .0001), and ecchymosis(z ≤ ĝ̂'10.1, p < .0001). C-clamp contributes to less oozing when hemostasis time is <30 min (z ≤ ĝ̂'2.2, p ≤ .03), and Femostop® is superior when time to hemostasis is >30 min (z ≤ ĝ̂'2.3, p ≤ .02). Not receiving eptifibatide (Integrilin) contributes to less ecchymosis (z ≤ ĝ̂'2.9, p ≤ .004). Conclusions: Nurses need to be vigilant when caring for patients who have a VC prior to femoral sheath removal and have received antiplatelet medications. Further research is needed to identify patient characteristics that may contribute to VCs.

Original languageEnglish (US)
Pages (from-to)391-398
Number of pages8
JournalNursing research
Volume54
Issue number6
DOIs
StatePublished - Nov 1 2005
Externally publishedYes

Fingerprint

Groin
Percutaneous Coronary Intervention
Blood Vessels
Ecchymosis
Thigh
Hematoma
Femoral Artery
Hemostasis
Tertiary Care Centers
Research Design
Nurses
Incidence
Research

Keywords

  • Complications
  • Coronary angioplasty

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Effects of three groin compression methods on patient discomfort, distress, and vascular complications following a percutaneous coronary intervention procedure. / Chlan, Linda; Sabo, Julie; Savik, Kay.

In: Nursing research, Vol. 54, No. 6, 01.11.2005, p. 391-398.

Research output: Contribution to journalReview article

@article{74f948ab78eb4158be7d2e76d76d6b57,
title = "Effects of three groin compression methods on patient discomfort, distress, and vascular complications following a percutaneous coronary intervention procedure",
abstract = "Background: Incidence of vascular complications (VCs) after sheath removal following a percutaneous coronary intervention procedure (PCIP) vary widely by the compression method used to achieve femoral artery hemostasis. Objective: To determine if one groin compression method causes the least discomfort and distress for patients and results in fewer VCs. Methods: Patients (n ≤ 306, mean age ≤ 62.3 years, 77{\%} male, 96.4{\%} Caucasian) undergoing PCIPs at a tertiary care center in the urban Midwest participated in this three-group experimental design study. They were randomly assigned to Femostop{\circledR}, C-clamp, or manual compression and rated level of groin discomfort and distress on a 0-10 Numeric Rating Scale (NRS) prior to, during, and after arterial compression was released. The groin area was assessed for any VCs (oozing, ecchymosis, hematoma) prior to sheath removal, after compression released, and 12 and 24 hr after sheath removal. Results: No significant differences were found by compression method for discomfort, distress, or VCs. Regardless of method, not having a VC prior to femoral sheath removal contributes to less oozing (z ≤ ĝ̂'3.1, p ≤ .0019), hematoma (z ≤ ĝ̂'9.4, p < .0001), and ecchymosis(z ≤ ĝ̂'10.1, p < .0001). C-clamp contributes to less oozing when hemostasis time is <30 min (z ≤ ĝ̂'2.2, p ≤ .03), and Femostop{\circledR} is superior when time to hemostasis is >30 min (z ≤ ĝ̂'2.3, p ≤ .02). Not receiving eptifibatide (Integrilin) contributes to less ecchymosis (z ≤ ĝ̂'2.9, p ≤ .004). Conclusions: Nurses need to be vigilant when caring for patients who have a VC prior to femoral sheath removal and have received antiplatelet medications. Further research is needed to identify patient characteristics that may contribute to VCs.",
keywords = "Complications, Coronary angioplasty",
author = "Linda Chlan and Julie Sabo and Kay Savik",
year = "2005",
month = "11",
day = "1",
doi = "10.1097/00006199-200511000-00005",
language = "English (US)",
volume = "54",
pages = "391--398",
journal = "Nursing Research",
issn = "0029-6562",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Effects of three groin compression methods on patient discomfort, distress, and vascular complications following a percutaneous coronary intervention procedure

AU - Chlan, Linda

AU - Sabo, Julie

AU - Savik, Kay

PY - 2005/11/1

Y1 - 2005/11/1

N2 - Background: Incidence of vascular complications (VCs) after sheath removal following a percutaneous coronary intervention procedure (PCIP) vary widely by the compression method used to achieve femoral artery hemostasis. Objective: To determine if one groin compression method causes the least discomfort and distress for patients and results in fewer VCs. Methods: Patients (n ≤ 306, mean age ≤ 62.3 years, 77% male, 96.4% Caucasian) undergoing PCIPs at a tertiary care center in the urban Midwest participated in this three-group experimental design study. They were randomly assigned to Femostop®, C-clamp, or manual compression and rated level of groin discomfort and distress on a 0-10 Numeric Rating Scale (NRS) prior to, during, and after arterial compression was released. The groin area was assessed for any VCs (oozing, ecchymosis, hematoma) prior to sheath removal, after compression released, and 12 and 24 hr after sheath removal. Results: No significant differences were found by compression method for discomfort, distress, or VCs. Regardless of method, not having a VC prior to femoral sheath removal contributes to less oozing (z ≤ ĝ̂'3.1, p ≤ .0019), hematoma (z ≤ ĝ̂'9.4, p < .0001), and ecchymosis(z ≤ ĝ̂'10.1, p < .0001). C-clamp contributes to less oozing when hemostasis time is <30 min (z ≤ ĝ̂'2.2, p ≤ .03), and Femostop® is superior when time to hemostasis is >30 min (z ≤ ĝ̂'2.3, p ≤ .02). Not receiving eptifibatide (Integrilin) contributes to less ecchymosis (z ≤ ĝ̂'2.9, p ≤ .004). Conclusions: Nurses need to be vigilant when caring for patients who have a VC prior to femoral sheath removal and have received antiplatelet medications. Further research is needed to identify patient characteristics that may contribute to VCs.

AB - Background: Incidence of vascular complications (VCs) after sheath removal following a percutaneous coronary intervention procedure (PCIP) vary widely by the compression method used to achieve femoral artery hemostasis. Objective: To determine if one groin compression method causes the least discomfort and distress for patients and results in fewer VCs. Methods: Patients (n ≤ 306, mean age ≤ 62.3 years, 77% male, 96.4% Caucasian) undergoing PCIPs at a tertiary care center in the urban Midwest participated in this three-group experimental design study. They were randomly assigned to Femostop®, C-clamp, or manual compression and rated level of groin discomfort and distress on a 0-10 Numeric Rating Scale (NRS) prior to, during, and after arterial compression was released. The groin area was assessed for any VCs (oozing, ecchymosis, hematoma) prior to sheath removal, after compression released, and 12 and 24 hr after sheath removal. Results: No significant differences were found by compression method for discomfort, distress, or VCs. Regardless of method, not having a VC prior to femoral sheath removal contributes to less oozing (z ≤ ĝ̂'3.1, p ≤ .0019), hematoma (z ≤ ĝ̂'9.4, p < .0001), and ecchymosis(z ≤ ĝ̂'10.1, p < .0001). C-clamp contributes to less oozing when hemostasis time is <30 min (z ≤ ĝ̂'2.2, p ≤ .03), and Femostop® is superior when time to hemostasis is >30 min (z ≤ ĝ̂'2.3, p ≤ .02). Not receiving eptifibatide (Integrilin) contributes to less ecchymosis (z ≤ ĝ̂'2.9, p ≤ .004). Conclusions: Nurses need to be vigilant when caring for patients who have a VC prior to femoral sheath removal and have received antiplatelet medications. Further research is needed to identify patient characteristics that may contribute to VCs.

KW - Complications

KW - Coronary angioplasty

UR - http://www.scopus.com/inward/record.url?scp=33644832971&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644832971&partnerID=8YFLogxK

U2 - 10.1097/00006199-200511000-00005

DO - 10.1097/00006199-200511000-00005

M3 - Review article

C2 - 16317360

AN - SCOPUS:33644832971

VL - 54

SP - 391

EP - 398

JO - Nursing Research

JF - Nursing Research

SN - 0029-6562

IS - 6

ER -