title: Early ambulation after diagnostic transfemoral catheterisation: a systematic review and meta-analysis.
abstract: BACKGROUND
  Femoral arterial puncture is the most common method of vascular access for angiography. Because of possible vascular events, all patients are restricted to strict immobilisation and bed rest for 2-24h, which is accompanied by back pain and discomfort.
  
  
  OBJECTIVE
  To assess the effects of the duration of bed rest after transfemoral catheterisation on the prevention of vascular complications and general discomfort, pain, urinary discomfort and patient satisfaction.
  
  
  METHODS
  We searched the Cochrane Library, MEDLINE, SCOPUS, CINAHL, Proquest Dissertations, Open SIGLE, Iranmedex and Irandoc.
  
  
  METHODS
  We included blinded or unblinded randomised controlled trials and quasi-randomised controlled trials that used two different durations of bed rest after angiography before the ambulation was permitted.
  
  
  METHODS
  Two reviewers separately assessed the quality of each study and extracted the data. We present dichotomous outcomes as odds ratios with 95% confidence intervals (CI) and continuous outcomes as mean differences with 95% CI.
  
  
  RESULTS
  Twenty studies involving a total of 4019 participants with a mean age of 59.5 years were included. The studies considered periods of bed rest ranging from 2 to 24h, which we compared in three main categories. There were no statistically significant differences between categories in the incidence of bleeding, haematoma, bruising, pseudoaneurysm, thrombus or arteriovenous fistula. Back pain intensity was assessed in four studies. Patients had significantly less back pain after 2-4h bed rest compared to 6h bed rest at 2h (mean difference: -0.70, 95% CI: -1.07, -0.32), 4h (mean difference: -0.60, 95% CI: -0.96, -0.24) and 6h of follow-up (mean difference: -3.77, 95% CI: -4.48, -2.92). One study that assessed urinary discomfort reported less urinary discomfort when bed rest lasted 4h compared to 12-24h (mean difference: -1.48; 95% CI: -2.37, -0.59). In addition, reduced bed rest time may significantly decrease the costs of hospital care.
  
  
  CONCLUSIONS
  This systematic review suggests that patients can be ambulated after 2-3h following transfemoral catheterisation, and that early ambulation had no significant effect on the incidence of vascular complications and may reduce back pain and urinary discomfort.
authors: Nursing and Midwifery Faculty, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mina
authors: M
authors: Mohammady
authors: Kazem
authors: K
authors: Heidari
authors: Ali
authors: A
authors: Akbari Sari
authors: Mitra
authors: M
authors: Zolfaghari
authors: Leila
authors: L
authors: Janani
mesh_terms: D002404:Catheterization; D004434:Early Ambulation; D005263:Femoral Artery; D006801:Humans; D017060:Patient Satisfaction
keywords: Bed rest; Catheterisation; Coronary angiography; Early ambulation; Femoral artery