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Objective: to compare the incidence of vascular complications in patients undergoing transfemoral cardiac catheterization with a 6F introducer sheath followed by 3-hour versus 5-hour rest. Methods: randomized clinical trial. Subjects in the intervention group (IG) ambulated 3 hours after sheath removal, versus 5 hours in the control group (CG). All patients remained in the catheterization laboratory for 5 hours and were assessed hourly, and were contacted 24, 48, and 72 h after hospital discharge. Results: the sample comprised 367 patients in the IG and 363 in the GC. During cath lab stay, hematoma was the most common complication in both groups, occurring in 12 (3%) IG and 13 (4%) CG subjects (P=0.87). Bleeding occurred in 4 (1%) IG and 6 (2%) CG subjects (P=0.51), and vasovagal reaction in 5 (1.4%) IG and 4 (1.1%) CG subjects (P=0.75). At 24-h, 48-h, and 72-h bruising was the most commonly reported complication in both groups. None of the comparisons revealed any significant between-group differences. Conclusion: the results of this trial show that reducing bed rest time to 3 hours after elective cardiac catheterization is safe and does not increase complications as compared with a 5-hour rest. ClinicalTrials.gov Identifier: NCT-01740856

Objective:To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Method: Cross-sectional study with retrospective data collection. Results: Overall, 345 patients were included; 116 (34%) experienced postprocedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. Conclusion: The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. DESCRIPTORSPain; Acute Pain; Pain Management; Endovascular Procedures; Nursing Care. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratoryAvaliação e manejo da dor em pacientes submetidos a procedimentos endovasculares em laboratório de hemodinâmica Evaluación y tratamiento del dolor en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterismo INTRODUCTIONEndovascular procedures involve the insertion of radiopaque catheters, via percutaneous venous or arterial puncture (femoral, brachial, or radial) under fluoroscopy guidance, to arrive at the desired location (heart, peripheral vessels, cerebral vessels). These procedures are carried out in catheterization laboratories ("cath labs") for purposes both diagnostic (evaluation of blood flow) and therapeutic (treatment of obstructions, stenoses, or correction of aneurysmal lesions) (1) . A common complaint of patients undergoing endovascular procedures is acute pain at the vascular access site or discomfort in the chest and lower back area, which may be related to bedrest, restricted movement of the accessed limb, to the trauma of vascular puncture itself, or to the potential vascular complications that may develop during the procedure (2)(3)(4) . However, other pain complaints, such as back pain or headache, are also very common in this setting (2)(3)(4)(5)(6) . Considering that the high turnover and dynamics of cath lab work may hinder proper care of pain, staff must pay special attention to assessment, management, and systematic recording of pain levels.Despite substantial growth of endovascular procedures in recent decades (3)(4)(5) , assessment of pain in the post-procedural period does not appear to be a major concern of care teams. Few studies have addressed this topic as a primary outcome in this setting (6)(7)(8) ; in others, pain was assessed a secondary or less important outcome (2) . It is known that inadequate management of postoperative pain can prolong hospitalization, increase healthcare expenditures, and have several clinical repercussions, including changes in blood pr...

Objetivo: analisar o conceito de trombose e identificar aplicações, atributos definidores, antecedentes, consequentes e referenciais empíricos. Método: análise de conceito, segundo Walker e Avant. Resultados: os atributos definidores mais citados foram trombo(s), tríade de Virchow e comprometimento total/parcial do fluxo sanguíneo. Os antecedentes mais frequentes foram câncer/uso de quimioterápicos, trombofilias e diabetes. Várias manifestações compuseram os consequentes, conforme o leito vascular comprometido. Os mais citados foram: acidente vascular cerebral ou acidente isquêmico transitório, infarto agudo do miocárdio e tromboembolismo pulmonar. Os referenciais empíricos se relacionaram a exames clínicos, testes de coagulação e escores de risco. A tomografia computadorizada foi o exame de imagem mais citado. Conclusão: a análise de conceito de trombose evidenciou o uso deste termo na literatura atual, bem como os atributos definidores, antecedentes, consequentes e referenciais empíricos. Este estudo agrega conhecimento à prática clínica de enfermeiros e pode contribuir com o refinamento dos sistemas de linguagens padronizadas.

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