Implementation of Evidence-Based Practice to Reduce Back Pain in Patients Undergoing Balloon Pulmonary Angioplasty
Keywords:
evidence-based practice, back pain, balloon pulmonary angioplasty, nursing careAbstract
Balloon pulmonary angioplasty (BPA) is a standard intervention for patients with pulmonary arterial hypertension caused by chronic thromboembolic obstructive vascular disease, and is a selective treatment for inoperable cases. The patients will need to undergo BPA several times throughout the course of their illness. BPA is performed by obtaining access through the femoral vein, which can cause complications such as bleeding or subcutaneous hematomas. Therefore, after the procedure, patients are advised to lie flat in a supine position with their leg extended for six hours to prevent complications and subsequent recurring back pain.
This article aims to present evidence-based management for back pain in patients with pulmonary arterial hypertension caused by chronic obstructive vascular disease after BPA. This evidence-based approach led to the development of the early ambulation program for BPA patients, which includes promoting early mobilization, adjusting head-of-bed height, and changing positions. After implementation in two patients who had previously undergone the procedure, it was found that they experienced notably less back pain compared to their previous procedures. Consequently, they felt more comfortable from the early mobilization without having experiencing bleeding or hematomas.
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Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). Eur Heart J. 2022;43(38):3618–731.
Puengpapat S, Pirompanich P. Incidence of chronic thromboembolic pulmonary hypertension in Thammasat University Hospital. Lung India Off Organ Indian Chest Soc. 2018;35(5):373–8. (in Thai)
Pussdhamma B. Pulmonary Hypertension and clinical cases. Khon Kaen: Faculty of medicine, Thailand; 2021.
Hoole SP, Coghlan JG, Cannon JE, Taboada D, Toshner M, Sheares K, et al. Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: the UK experience. Open Heart. 2020;7(1):e001144.
Kjellstrom B, Ryftenius H, Landenfelt-Gestre LL, Ivarsson B. Outpatient specialist clinics for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension in the Nordic countries. Pulm Circ. 2020;10(4):2045894019897499.
Cale R, Ferreira F, Pereira AR, Saraiva C, Santos A, Alegria S, et al. Balloon pulmonary angioplasty protocol in a Portuguese pulmonary hypertension expert center. Rev Port Cardiol. 2021;40(9):653–65.
Phuengsri K, Panyasuk S. Effects of care protocols after transfemoral coronary angiography, cardiac catheterization laboratory unit, Lampang Hospital. Journal of Health Science. 2019;28(6):1077–91. (in Thai)
Hilario TS, Santos SM, Kruger J, Goes MG, Casco MF, Rabelo-Silva ER. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory. Rev Esc Enferm USP [Internet]. 2017 [cited 2022 Sep 2]. Available from: http://www.scielo.br/j/reeusp/a/XTSp8rVcfhKdFLBhbxDNMSx/?lang=en
Piva CD, Vaz E, Moraes MA, Goldmeyer S, da Costa Linch GF, de Souza EN. Discomfort reported by patients after cardiac catheterization using the femoral or radial approaches. Rev Bras Cardiol Invasiva Engl Ed. 2014;22(1):36–40.
van Thor MCJ, Lely RJ, Braams NJ, ten Klooster L, Beijk MAM, Heijmen RH, et al. Safety and efficacy of balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension in the Netherlands. Neth Heart J. 2020;28(2):81–8.
Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150(3699):971-9.
Siegele DS. Pain and suffering: the gate control theory. Am J Nurs 1974; 74(3):498- 502.
Chaiyagad C, Ruaisungnoen W. Back pain management for patients underwent transfemoral coronary angiography: nurse’s role. Srinagarind Med J. 2021;36(1):111-8. (in Thai).
Leaungsomnapa, S, Ngamkham, S. Attention to pain. The Journal of Prapokklao Hospital Clinical Medical Education Center. 2013;30(1):83–93. (in Thai)
Kobrossi S, Tamim H, Dakik HA. Vascular complications of early (3h) vs standard (6h) ambulation post-cardiac catheterization or percutaneous coronary intervention from the femoral artery. Int J Cardiol. 2014; 176(3):1067–9.
Burn KL, Marshall B, Scrymgeour G. Early mobilization after femoral approach diagnostic coronary angiography to reduce back pain. J Radiol Nurs. 2015;34(3):162–9.
Cha NH, Sok S. Effects of position change on lumbar pain and discomfort of Korean patients after invasive percutaneous coronary intervention: a RCT study. J Phys Ther Sci. 2016;28(10):2742–7.
Fereidouni Z, Morandini MK, Kalyani MN. The efficacy of interventions for back pain in patients after transfemoral coronary angiography: A rapid systematic review. J Vasc Nurs. 2019;37(1):52–7.
Turen S, Yilmaz RA, Yesiltepe N, Bektas I. Effect of the head of bed elevation on back pain after elective coronary angiography: A randomized controlled trial. Appl Nurs Res. 2022;64:151571.
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