Hostname: page-component-848d4c4894-sjtt6 Total loading time: 0 Render date: 2024-07-02T15:43:56.910Z Has data issue: false hasContentIssue false
  • English
  • Français

Safety and feasibility of the paediatric post-cardiac catheterisation Wrap: a pilot study

Part of: Interventional Cardiology

Published online by Cambridge University Press:  02 February 2022

Jennifer Haley ,
Shannon L. Engstrand ,
Alexandra Cole Open the ORCID record for Alexandra Cole [Opens in a new window] ,
Sara Schenkel ,
Karen Hinsley ,
Brenda Brawn ,
Jesse Esch ,
Juan Ibla  and
Michele DeGrazia
Jennifer Haley*
Affiliation:
Cardiac Catheterization Lab, Boston Children’s Hospital, Boston, MA, USA
Shannon L. Engstrand
Affiliation:
Cardiovascular and Critical Care, Boston Children’s Hospital, Boston, MA, USA
Alexandra Cole
Affiliation:
Cardiovascular and Critical Care, Boston Children’s Hospital, Boston, MA, USA
Sara Schenkel
Affiliation:
Division of Pediatric Global Health, Massachusetts General Hospital, Boston, MA, USA
Karen Hinsley
Affiliation:
Cardiac Catheterization Lab, Boston Children’s Hospital, Boston, MA, USA
Brenda Brawn
Affiliation:
Cardiac Catheterization Lab, Boston Children’s Hospital, Boston, MA, USA
Jesse Esch
Affiliation:
Cardiac Catheterization Lab, Boston Children’s Hospital, Boston, MA, USA
Juan Ibla
Affiliation:
Cardiac Catheterization Lab, Boston Children’s Hospital, Boston, MA, USA
Michele DeGrazia
Affiliation:
Cardiovascular and Critical Care, Boston Children’s Hospital, Boston, MA, USA
*
Author for correspondence: J. Haley, Cardiac Catheterization Lab, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Tel: +(617) 355-6189; Fax: (617) 730-0652. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The paediatric post-cardiac catheterisation Wrap (Wrap), an innovative medical safety device, swaddles young paediatric patients in a supine position aiding in immobilisation post-cardiac catheterisation. This pilot study investigated the feasibility and safety of using the Wrap on young paediatric patients during their bed rest period following cardiac catheterisation with femoral access.

Setting:

Boston Children’s Hospital Cardiac Catheterization Lab.

Participants:

20 patients, ages 1–5 years and weighing 3–25 kg.

Methods:

Investigator-developed tools used to collect data included the Demographic and Outcome Measures Data Tool, the Parent/Caregiver Satisfaction, and Provider Ease of Use tools. They measured:

  1. 1. The feasibility of using the Wrap

  2. 2. Wrap ease of use from the nurse providers’ perspective

  3. 3. Parent satisfaction related to the Wrap

  4. 4. Frequency of Wrap non-bleeding-related adverse events

  5. 5. Frequency of rebleeding at femoral groin access sites

Results:

The Wrap was feasible and safe; increased nurse provider satisfaction by allowing visualisation of the groin access sites while minimising the need for hands-on care; and increased parent satisfaction by allowing parents to hold and provide comfort while their child was on bed rest.

Implications for Research:

The Wrap is a safe alternative to the current practice of swaddling with a bath blanket. Further studies are warranted to assess the Wrap’s effectiveness in reducing the incidence of rebleeding events in the post-cardiac catheterisation period and explore clinical use outside of the Cardiac Catheterization Lab.

Keywords

Pediatriccardiac catheterizationhemostasisre-bleedimmobilization
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 1 , January 2023 , pp. 11 - 20
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lehmann, KG, Ferris, ST, Heath-Lange, SJ. Maintenance of hemostasis after invasive cardiac procedures: implications for outpatient catheterization. J Am Coll Cardiol 1997; 30: 444–451. DOI 10.1016/S0735-1097(97)00156-3.CrossRefGoogle ScholarPubMed
Hoerl, G, Tafeit, E, Leschnik, B, et al. Cardiac catheterization: haemostatic changes in pediatric versus adult patients. J Thromb Thrombolysis 2011; 32: 372–377. DOI 10.1007/S11239-011-0606-5.CrossRefGoogle ScholarPubMed
Vitiello, R, Mccrindle, BW, Nykanen, D, Freedom, RM, Benson, LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32: 1433–1440. DOI 10.1016/S0735-1097(98)00396-9.CrossRefGoogle ScholarPubMed
Molin, AD, Faggiano, F, Bertoncini, F, et al. Bed rest for preventing complications after transfemoral cardiac catheterisation: a protocol of systematic review and network meta-analysis. Syst Rev 2015; 4: 1–6. DOI 10.1186/S13643-015-0036-0.Google Scholar
Mohammady, M, Heidari, K, Akbari Sari, A, Zolfaghari, M, Janani, L. Early ambulation after diagnostic transfemoral catheterisation: a systematic review and meta-analysis. Int J Nurs Stud 2014; 51: 39–50. DOI 10.1016/j.ijnurstu.2012.12.018.CrossRefGoogle ScholarPubMed
Antonov, NK, Ruzal-Shapiro, CB, Morel, KD, et al. Feed and Wrap MRI technique in infants. Clin Pediatr (Phila) 2016; 56: 1095–1103. DOI 10.1177/0009922816677806.CrossRefGoogle ScholarPubMed
Vlajkovic, GP, Sindjelic, RP. Emergence delirium in children: many questions, few answers. Anesth Analg 2007; 104: 84–91. DOI 10.1213/01.ane.0000250914.91881.a8.CrossRefGoogle ScholarPubMed
Mason, KP. Paediatric emergence delirium: a comprehensive review and interpretation of the literature. Br J Anaesth 2017; 118: 335–343. DOI 10.1093/bja/aew477.CrossRefGoogle ScholarPubMed
Kim, DH, Roh, GU, Lee, YB, Choi, CI, Lee, JM, Chae, YJ. Prediction of emergence agitation using withdrawal reaction following rocuronium injection in preschool-aged patients undergoing inguinal herniorrhaphy: a preliminary exploratory observational trial. Ther Clin Risk Manag 2018; 14: 189–194. DOI 10.2147/TCRM.S154264.CrossRefGoogle ScholarPubMed
Abidin, HZ, Omar, SC, Mazlan, MZ, et al. Postoperative maladaptive behavior, preoperative anxiety and emergence delirium in children undergone general anesthesia: a narrative review. Glob Pediatr Health 2021; 8: 1–9. DOI 10.1177/2333794X211007975.Google Scholar
Sparks, LA, Setlik, J, Luhman, J. Parental holding and positioning to decrease IV distress in young children: a randomized controlled trial. J Pediatr Nurs 2007; 22: 440–447. DOI 10.1016/j.pedn.2007.04.010.CrossRefGoogle ScholarPubMed
Koller, D, Goldman, RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs 2012; 27: 652–681. DOI 10.1016/J.PEDN.2011.08.001.CrossRefGoogle ScholarPubMed
Artunduaga, M, Liu, CA, Morin, CE, et al. Safety challenges related to the use of sedation and general anesthesia in pediatric patients undergoing magnetic resonance imaging examinations. Pediatr Radiol 2021; 51: 724–735. DOI 10.1007/s00247-021-05044-5.CrossRefGoogle Scholar
Chen, E, Zeltzer, LK, Craske, MG, Katz, ER. Children’s memories for painful cancer treatment procedures: implications for distress. Child Dev 2000; 71: 933–947. DOI 10.1111/1467-8624.00200.CrossRefGoogle ScholarPubMed
Leroy, PL, Costa, LR, Emmanouil, D, Van Beukering, A, Franck, LS. Beyond the drugs: non-pharmacological strategies to optimize procedural care in children. Curr Opin Anaesthesiol 2016; 29: S1–S13. DOI 10.1097/ACO.0000000000000312.CrossRefGoogle Scholar
Derieg, S. An overview of perioperative care for pediatric patients. AORN J 2016; 104: 4–10. DOI 10.1016/j.aorn.2016.05.001.CrossRefGoogle ScholarPubMed
Harris, PA, Taylor, R, Minor, BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019; 95: 103208. DOI 10.1016/j.jbi.2019.103208.CrossRefGoogle ScholarPubMed
Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377–381. DOI 10.1016/j.jbi.2008.08.010.CrossRefGoogle ScholarPubMed
Braun, V, Clarke, V. Thematic analysis. In:  Cooper H, Camic PM, Long DL, Panter AT, Rindskopf D, Sher KJ (eds). APA handbook of research methods in psychology, Vol 2: Research designs: quantitative, qualitative, neuropsychological, and biological. American Psychological Association, 2012: 57–71. DOI 10.1037/13620-004.CrossRefGoogle Scholar
Moriguchi, Y, Hiraki, K. Prefrontal cortex and executive function in young children: a review of NIRS studies. Front Hum Neurosci 2013; 7: 1–9. DOI 10.3389/FNHUM.2013.00867.CrossRefGoogle ScholarPubMed
Center on the Developing Child at Harvard University. Building the Brain’s “Air Traffic Control” System: How Early Experiences Shape the Development of Executive Function: Working Paper No. 11, 2011 Google Scholar
Pomicino, L, Maccacari, E, Buchini, S. Levels of anxiety in parents in the 24 hr before and after their child’s surgery: a descriptive study. J Clin Nurs 2018; 27: 278–287. DOI 10.1111/JOCN.13895.CrossRefGoogle ScholarPubMed
Cohen, LL. Behavioral approaches to anxiety and pain management for pediatric venous access. Pediatrics 2008; 122: S134–S139. DOI 10.1542/peds.2008-1055f.CrossRefGoogle ScholarPubMed
Aiyagari, V, Diringer, MN. Fever control and its impact on outcomes: what is the evidence? J Neurol Sci 2007; 261: 39–46. DOI 10.1016/j.jns.2007.04.030.CrossRefGoogle ScholarPubMed
Kriesberg, CP, Little, JM, Mohr, L, Kato, K. Reducing pressure injuries in a pediatric cardiac care unit: a quality improvement project. J Wound, Ostomy Cont Nurs 2018; 45: 497–502. DOI 10.1097/WON.0000000000000477.CrossRefGoogle Scholar