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After cardiac catheterisation, haemostasis is usually achieved by manual compression of the puncture site. The patient is then laid flat, allowed to sit up and then to mobilise—a process taking considerably longer than the procedure itself, and possibly involving more prolonged bed occupancy than is necessary. Well conducted, randomised, controlled trials of patient position (supine or upright) and duration of rest after catheterisation, with consistent use of the small calibre catheters used in contemporary practice, and robust definitions of haemorrhagic complications, are few, and include only small numbers of patients.1–3 Consequently, a poll of 32 institutions in the UK in the year 2000 (conducted by SDP) revealed that the length of time patients are kept supine varies from 0–6 hours (mean 2.2 hours), with bed rest lasting from 3–24 hours (mean 5.7 hours).
We aimed to examine the safety of early sit-up and mobilisation after routine cardiac catheterisation in contemporary practice.
We performed a prospective, randomised, open label, controlled trial in which patients, who had undergone elective 6 French cardiac catheterisation via the femoral artery, were randomly assigned to either 4.5 hours bed rest, with sit-up (elevation of the head of the bed to 60°) after 4 hours (group A) or 2.5 hours bed rest, with sit-up after 1 hour (group B). The primary end point was vascular complications, comprising …