104 PROCEEDING BOOK
The 2
nd
International Conference on Health Science 2015
transradial cardiac catheterization. Changes in the blood clotting in case of patients with cardiac catheterization action will increase the occurrence hematoma
11
. The amount of medication that could affect blood coagulation will affect the incidence of hematoma.
Care of post catheterization patients using more than one anticoagulant drugs requires monitoring of more stringent bleeding such as APTT and PPT serial examinations until the
effects of the drug runs out compared to just one drug.
c. Sheath size and incidence of hematoma.
Katetrisasi patients who underwent heart by using a 6F sheath size can affect the incidence of hematoma p value = 0.00, with the infl uence of 31.6 times the hematoma.
The incidence of hematoma can be reduced by using the size of the catheter with a smaller diameter, such measures can reduce complications hematoma signifi kan
15
. The size of the sheath catheter compared to the diameter of the artery becomes becomes
unbalanced, the condition can be explained if the diameter of the outer sheath larger size may lead to increased blood vessel damage, the effect of stretching on the sheath size and
effect when the sheath is in the arteries to be the cause of damage intima layer of the arterial wall and trigger hematoma
12
. In the transradial cardiac catheterization in using larger sheath sizes 6F should be
considered as an effect on the incidence of hematoma that if had to use large sized sheath, the post-heart catheterization need to be monitored in case of the incidence of hematoma,
especially during sheath retraction.
Care of patients post cardiac catheterization using a 6F sheath size needs to be monitored intensely, especially at the insertion sheath puncture area is more intense than
the size of the 5F sheath.
d. Systolic blood pressure and incidence of hematoma
Patients who underwent cardiac catheterization with systolic blood pressure 140 mmHg effect on the incidence of hematoma p value = 0.00, with 7.9 times the infl uence of
the hematoma. Systolic blood pressure 140 mmHg increase the incidence of hematoma after cardiac catheterization; Blood pressure above 150 mmHg can increase bleeding and
hematoma at 17.5
17
. Systolic blood pressure 140 mmHg lowers the level of elasticity of blood vessels and
in case of trauma to the blood vessels would be easier pecah
18
. In patients who performed transradial cardiac catheterization acts upon needle insertion at the radial artery where the
value of systolic blood pressure 140 mmHg, the blood vessels easily rupture rigid so it triggered the hematoma.
Patients will be taken to the cardiac catheterization systolic blood pressure 140 mmHg insertions should be performed carefully in order to avoid repetition.
e. Puncture frequency and incidence of hematoma
Katetrisasi patients who underwent twice or more cardiac puncture infl uence on the incidence of hematoma p value = 0.017, with 4.4 times the infl uence of the hematoma.
Arterial puncture more than once during the cardiac catheterization procedure may increase the incidence of complications hematoma 7.9 times
16
. The act of repetition insertion or needle insertion on the action that failed catheterization
can cause damage to blood vessels and increase the occurrence of hematoma
6
. Failure
“Optimizing The Quality of Life Children Under SDGs” Sustainable Development Goals
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and radial artery puncture repetition on the action of transradial cardiac catheterization can increase damage or injury to the blood vessels, causing bleeding and increase the incidence
of hematoma.
Make sure the proper location before stabbing at the radial artery, use the touch pulsasinya clear and precise needle punctures so cultivated once successful, because in
case of failure will increase the risk of hematoma.
f. TR Band and Genesis Hematoma
Patients who underwent cardiac catheterization with the use of TR Band with air pressure ofl ess than 13 cc may affect the incidence of hematoma p value = 0.00, with the infl uence
of 13.9 times the hematoma. There is no type of effective compression tool that can provide the proper pressure and does not cause complications hematoma
19
. The emphasis of the radial artery using TR Band with pressure 13 cc is not always
safe because of a complaint against vascularization to the area distal from the radial artery as well as the pain that needs to be reduced pressure of 13 cc, with pressure reduction will
lead to injury of blood vessels have not been returned or hemoestasis process has not been formed so bleeding and hematoma occurred
15
. TR pressure reduction Band performed before his time with the consideration in the
event of disruption of blood fl ow to distal and pain resulting hemodynamic disturbances are likely due to the use of TR Band. Pengurakan pressure TR Band performed but is likely to
occur hematomas so long as the reduction is to be monitored the occurrence of hematoma and circulation to the area distal to the ulnar artery pulsation felt so comfort of patients remain
unnoticed.
g. Body mass index and incidence of hematoma
Patients who underwent cardiac catheterization with normal Body Mass Index and not normal no effect on the incidence of hematoma p value = 0.661 greater than 0.05, with much
infl uence the occurrence of hematoma 0 times. Based on the analysis by the Chi-Square data showed that there were no differences in the incidence of hematoma proportion with
body mass index p value = 0.661; 0.5, with OR = 0 means that patients with a BMI over with normal BMI did not infl uence the occurrence of hematoma.
Body mass index indicates overweight where there will be a buildup of thick muscle mass which includes the area of the femoral and radial diradialis bit. The thickness of the muscle in
the insertion area will affect the conduct arterial insertion in the cardiac catheterization action that will have diffi culty in fi nding areas that will be in cannulation artery and the manipulation
of the catheter during catheterization jantung action
20
. The thickness of the muscle in the femoral area is thicker than in the radial artery area, so that the diffi culties at the femoral
artery access is more diffi cult than the radial artery that obesity will affect hematoma in transfemoral compared transradial cardiac catheterization.
Based on the test results of the bivariate analysis with chi square test, there are fi ve variables: the type of drug administration, the size of the sheath, the value of blood pressure,
puncture and TR Band frequency, the effect on the incidence of hematoma, while variables body mass index showed no effect on the incidence of hematoma.
The variables that most infl uence on the incidence of hematoma with OR greatest value is variable sheath size is 31.6, while the smallest infl uence on the incidence of hematoma
is the frequency factor puncture with an OR of 4.4.
