Elevate to Alleviate – Evidence Based Vascular Nursing Study

Abstract

Nicola Ielapi,1,2,* Michele Andreucci,3,* Umberto Marcello Bracale,4 Davide Costa,1,5 Egidio Bevacqua,6 Nicola Giannotta,1,6 Maria Grazia Bevacqua,7 Giuseppe Filiberto Serraino,7 Pasquale Mastroroberto,7 Michele Provenzano,6 Raffaele Serra1,6 1Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology” at the Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; 2Department of Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy; 3Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; 4Department of Public Health, Vascular Surgery Unit, University Federico II of Naples, Naples, Italy; 5Department of Law, Economics and Sociology, University Magna Graecia of Catanzaro, Catanzaro, Italy; 6Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, 88100, Italy; 7Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy*These authors contributed equally to this workCorrespondence: Raffaele SerraDepartment of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy, Email [email protected]: Venous return in the circulatory system of lower limbs results from the interaction of several mechanisms and reflects the balance between blood inflow and outflow. Blood outflow improves during the lying position especially with leg elevation both in patients with chronic venous disease (CVD) and in healthy subjects in sedentary settings with short-term immobilization. This study evaluated the level of comfort of hospital inpatients, without CVD, lying with a moderate leg elevation during hospital stay.Methods: This was a clinical trial examining 60 consecutive patients referred to vascular surgery, cardiac surgery, and nephrology units. After inclusion, patients were randomly assigned to two groups: A (leg elevation) in which patients were made to lie in the hospital bed with moderate elevation of the legs, and B (no leg elevation) in which patients were made to lie in the hospital bed without leg elevation.Results: The whole population consisted of 40 patients undergoing leg elevation (group A) and 20 without leg elevation (group B). During each day of hospitalization, measurements such as ankle and calf circumference, heart rate, blood pressure, and body temperature were collected. Subjective data such as perceived heaviness in the lower limbs, comfort perception and hours of sleep were also collected. In this study, patients of group A recorded a decrease in calf and ankle circumference (delta in ankle and calf circumference (difference between end of study visit and baseline visit) were significantly decreased in group A vs group B (p< 0.001 for both sides), and patients perceived less leg heaviness and even reported more leg comfort compared to patients of Group B (p< 0.001)). Among patients of group A, the bigger advantage in terms of comfort perception was recorded in patients with 15° leg elevation.Conclusion: Moderate leg elevation during hospital stay seems to effectively improve leg comfort in hospitalized patients.Keywords: venous system, lower limb, circulation, leg elevation, hospital stay, vein symptoms, leg discomfort

Keywords

• venous system
• lower limb
• circulation
• leg elevation
• hospital stay
• vein symptoms
• leg discomfort