Ask an answerable question (PICO)：
Cardiac catheterization is currently the most common examination in the diagnosis and treatment of coronary artery disease worldwide. The puncture from the femoral artery has a higher risk than the radial artery, and it is prone to related vascular complications including hemorrhage and hematoma.
In order to avoid vascular-related complications following cardiac catheterization in the femoral artery, the routine care were keeping a supine position and fixed the affected limb, and avoiding semi-sitting, regardless of whether the arterial sheath has been indwelled or the catheter has just been removed, causes the above-mentioned complications. However, such restrictive conventional measures easily lead to physical discomfort complains, such as back pain, coughing, and even though unable to effectively expand the lungs and keep good airway ventilation. This evidence-based researching aims to understand that is it at high risk of vascular-related complications by raising the head of the bed after patients undergoing femoral artery cardiac catheterization?
The Method and Analysis of Literature Review：
We started to search the PICO-related synonyms, MeSH term and Emtree in four databases including CEPS, PubMed, Embase and CINHAL. And then we used Bollinger logic principles OR、AND、filter to identify relevant peer-reviewed articles. We limited articles published between 2015 and 2020, the language in English and design in systematic review (SR), SR and meta-analysis (MA), and randomized controlled trails (RCTs). One RCT and one randomized-controlled quasi-experimental study were selected from a total of 28 articles, after screening, meet the conditions as two RCTs documents. The literature was reviewed by the 2020 CASP evaluation tool, and the level of evidence was evaluated by Oxford Centre for Evidence-based Medicine Levels of Evidence (2011).
Critical Appraisal：
The level of evidence of two studies are assigned to level II after CASP 2020 and Oxford Centre for Evidence-based Medicine Levels of Evidence (2011) critical appraisal. Two studies assessed does raise head of the bed and change posture can cause vascular-related complications following patients received cardiac catheterization. Studies have found that a gradually raise the head of the bed or change posture within eight hours of following cardiac catheterization, it not only can increase patients’ physical comfort, lower low back pain and urine retention, better lung expansion, and reduce unnecessary aspiration pneumonia. In addition, it does not increase the incidence of vascular-related complications (P>0.05).
Results, Conclusions and Recommendations：
After the process of evidence-based review, we found that raising the head of the bed following patients ongoing cardiac catheterization would not cause vascular-related complications. In the opposite, it can enhance patient comfort and reduce post-procedure bed rest pain. Suggested that the results of evidence-based search can be put to practice in the future.
