The Effect of Modified Supine Position on Urinary Elimination After Percutaneous Coronary Intervention
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Standardized Mini Mental State Examination (SMMSE)
研究概览
简要总结
Urinary retention is also a frequent complication after percutaneous coronary intervention applied via the femoral artery. The inability to manage this situation effectively leads to serious complications in the long term, prolonging the length of hospital stay and increasing the cost, as well as impairing the participants's comfort. In the investigators's country, no study has been found in which the effectiveness of an appropriate and effective lying position in performing urinary drainage in the bed in order to ensure urinary emptying and to minimize possible complications in participants undergoing percutaneous coronary intervention has been found. One study states that the modified supine position is an effective intervention on the amount of urine output in participants. In another study, it was determined that different degrees of bed height and position changes would be safe and effective in reducing regional pain and vascular complications (hematoma, bleeding, thrombosis, bruising, etc.). In this context, the aim of the study is to reveal the effect of the modified supine position on providing effective urinary drainage (hourly and 24-hour urine output) and preventing possible complications (urinary retention) in participants undergoing percutaneous coronary intervention.
详细描述
Cardiovascular diseases are an important health problem in the world and in the investigators's country, and are among the leading causes of death in adults. According to the 2017 data of the Coronary Heart Disease and Risk Factors in Turkish Adults (TEKHARF) study, it is estimated that there are approximately 3.5 million coronary heart patients in the investigators country, this number increases by 4% per year in the investigators aging population, and 210 thousand individuals die from coronary heart disease annually.
Percutaneous coronary intervention is a revascularization method used in the treatment of coronary artery disease. Complications related to vascular access sites occur in 5-7% of patients undergoing percutaneous coronary intervention. The most common coronary vascular intervention complications are; hematoma, bleeding at the vascular access site, arterial pseudoaneurysm and arteriovenous fistula development. According to the latest guidelines and literature, bed rest ranges from 6 to 24 hours, especially after percutaneous coronary intervention applied via femoral route in order to prevent bleeding-related complications.
Another complication encountered after percutaneous coronary intervention applied through the femoral artery is difficulties in urinary drainage. Having long rest periods in the supine position and being able to urinate only in the supine position, without allowing knee bending, in order to prevent complications that may develop at the application site during this period; It can cause difficulty in emptying urine, incomplete emptying of the urine from the bladder, and retention.
In our country, no study has been found in which the effectiveness of an appropriate and effective lying position in performing urinary drainage in the bed in order to ensure urinary emptying and to minimize possible complications in patients undergoing percutaneous coronary intervention has been found. One study, states that the modified supine position is an effective intervention on the amount of urine output in patients. In another study, it was determined that different degrees of bed height and position changes would be safe and effective in reducing regional pain and vascular complications (hematoma, bleeding, thrombosis, bruising, etc.). In this context, the aim of the study is to reveal the effect of the modified supine position on providing effective urinary drainage (hourly and 24-hour urine output) and preventing possible complications (urinary retention) in patients undergoing percutaneous coronary intervention.
Formation of the Experimental Group and Interventions:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 30 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Diagnosed with cardiovascular disease,
- •Elective hospitalizations and transfemoral percutaneous coronary intervention,
- •Ability to urinate without problems and express the desire to urinate,
- •Able to communicate verbally,
- •Not having any disability in terms of consciousness and sensory organs (Mini Mental Score 25 and above),
- •Adult patients who volunteer to participate in the study will be included.
排除标准
- •Participants who underwent intraoperative foley catheterization, who had a history of prostate hyperplasia, prostate carcinoma, urinary tract infection, urological disease, sensory disorders or neurological problems, who had the procedure performed under spinal or epidural anesthesia, who cannot tolerate the supine position according to the clinical procedure, and who cannot communicate in Turkish will not be included.
结局指标
主要结局
Standardized Mini Mental State Examination (SMMSE)
时间窗: İmmediately before percutaneous coronary intervention, baseline.
SMMSE scores of 23 and below are considered to be indicative of cognitive impairment. In this study, patients with 25 points and above will be included in the study.
Time taken to reach first voiding function.
时间窗: Measurement of the time from the moment the bedpan/duck/urine bottle was placed to the end of urination in participants who felt the urge to urinate within the first 6 hours after coronary angiography.
This time will give the first urination time and will be evaluated at 4 levels. These 4 levels; Level 0: Urinating within 1 minute, Level 1: Urinating within 1 to 30 minutes, Level 2: Urinating within 1 to 30 minutes and needing assistance such as massage or heat pack to do so, Level 3: Unable to urinate by self or other means of assistance and needs a urinary catheter. Levels 2 to 3 are considered impaired voiding.
次要结局
- Change in anxiety as measured by Visual Analog Scale (VAS-A).(İmmediately before percutaneous coronary intervention and immediately after the first voiding.)
- Change in pain as measured by Visual Analog Scale.(İmmediately before percutaneous coronary intervention and immediately after the first voiding.)
- Evaluation of the presence of thrombosis in the extremity where the femoral artery is located where percutaneous coronary intervention is performed.(The first 6 hours after the procedure.)
- Follow-up of post-procedure fluid intake and urine output as measured by the European Association of Urology bladder diary.(From the 6th hour to the 24th hour after the procedure.)
- It is the evaluation of initial voiding volume and urinary retention volume.(Immediately after first urination.)
研究者
Esra Karagoz
Principal Investigator
Istanbul University - Cerrahpasa (IUC)