# Early Mobilization after Cardiac Catheterization via Femoral Artery: A Systematic Review and Meta-Analysis

## TL;DR

This study finds that early mobilization after cardiac catheterization is safe and reduces back pain and urinary retention.

## Contribution

The study identifies optimal timing for early mobilization after trans-femoral cardiac catheterization.

## Key findings

- Early mobilization reduces back pain and urinary retention without increasing complications.
- Mobilizing patients within 3-4 hours after the procedure shows the most significant benefits.
- Advancing mobilization to 2-4 hours is safe and feasible in enhanced recovery pathways.

## Abstract

Early mobilization is one of the essential components of
enhanced recovery after surgery (ERAS) pathways and has been shown to reduce
complications and optimize patient outcomes. However, the effect of early
mobilization for patients who undergo trans-femoral cardiac catheterization and
the time for optimal mobilization timing remains controversial. We aimed to
identify the safety of early mobilization and provide the optimum timing for
early mobilization for patients undergoing trans-femoral cardiac catheterization.

We searched MEDLINE, EMBASE, PubMed, Web of Science, Cochrane
databases of systematic reviews, CINAHL, SCOPUS, China National Knowledge
Infrastructure (CNKI), Wan Fang Database, and Chinese Science and Technology
Periodical Database (VIP) comprehensively for randomized controlled trials
associated with early mobilization, to explore its effects on patients after a
trans-femoral cardiac catheterization. The risk of bias and heterogeneity of
studies was assessed using the Revised Cochrane risk-of-bias tool for randomized
trials (RoB 2) and I2 index, respectively. The comprehensive Meta-analysis
(CMA) was adopted to perform the meta-analysis.

We identified
14 trials with 2653 participants. Early mobilization was associated with
significant decrease in back pain (mean difference (MD) = 0.634, 95% CI:
0.23–1.038; p = 0.002), especially in patients receiving instruction
for early mobilization in 3 h~4 h versus 5 h~6 h
(MD = 0.737, 95% CI: 0.431–1.043; p = 0.000) and 12 h versus 24 h (OR
= 5.504, 95% CI: 1.646–18.407; p = 0.006) categories. The results of
subgroup analysis also showed a significant risk reduction in urinary retention
by early mobilization in 12 h versus 24 h (OR = 5.707, 95% CI: 1.859–17.521;
p = 0.002) category.

Early mobilization has not
been shown to increase the risk of bleeding, hematoma, pseudoaneurysm, urinary
retention, and pain at the puncture site after trans-femoral cardiac
catheterization. Early mobilization is a practical initiative in ERAS, and it may
be safe and feasible to advance the mobilization to 2 h~4 h.