Effectiveness of Using Cold Esaline Compress in Reducing the Area of Hematoma after Coronary Intervention Percutaneous Femoral Access
DOI:
https://doi.org/10.37287/ijghr.v8i4.1568Keywords:
cold therapy, esaline cold compress, hematoma, nursing care, transfemoral PCIAbstract
Percutaneous Coronary Intervention (PCI) with a transfemoral approach is an invasive procedure commonly used in the management of coronary artery disease. This study aims to evaluate the effectiveness of esaline cold compress application in reducing hematoma size at the femoral access site in patients undergoing PCI. This study employed a Randomized Controlled Trial (RCT) design with a consecutive sampling technique. The sample consisted of 80 respondents who underwent transfemoral PCI, including 40 respondents in the intervention group and 40 respondents in the control group. Participants were recruited consecutively based on predetermined inclusion and exclusion criteria and were randomly allocated into intervention and control groups. The intervention group received esaline cold compresses applied to the femoral access area after sheath removal, while the control group received standard care. Data were collected through observation of hematoma size, pain scale, and patient comfort for 24 hours post-procedure. Data analysis was conducted using the Mann–Whitney U test with a significance level of 0.05. The results showed that the characteristics of respondents in both groups were relatively homogeneous. There was a statistically significant difference in hematoma size between the intervention group and the control group (p = 0.001 < 0.05). Specifically, the group receiving esaline cold compresses demonstrated a mean rank of 30.41 with a total rank of 1216.50. The application of esaline cold compresses was proven to be statistically and clinically effective in preventing and minimizing the extent of hematoma following femoral access PCI.
References
Abubakar, M., Javed, I., Rasool, H. F., Raza, S., Basavaraju, D., Abdullah, R. M., Ahmed, F., Salim, S. S., Faraz, M. A., Hassan, K. M., & Hajjaj, M. (2023). Advancements in Percutaneous Coronary Intervention Techniques. Cureus, 15(7), 1–9. https://doi.org/10.7759/cureus.41311
Afriyanti, R., Pangemanan, J., & Palar, S. (2025). Hubungan Antara Perilaku Merokok Dengan Kejadian Penyakit Jantung Koroner. Jurnal E-Clinic (ECl), 3(1), 98–102. https://doi.org/https://doi.org/10.35790/ecl.v3i1.6747
Alba, B. K., Castellani, J. W., & Charkoudian, N. (2019). Cold-induced cutaneous vasoconstriction in humans: Function, dysfunction and the distinctly counterproductive. Experimental Physiology Journal. https://doi.org/10.1113/EP087718
Andreiani, F. Y., Nurachmah, E., & Muhsinin, M. (2025). Pengalaman Menjalani Percutaneous Coronary Intervention (PCI) Untuk Mempertahankan Quality of Life (QOL) yang Dipersepsikan Pasien Dengan Acute Coronary Syndrome (ACS). Jurnal Locus: Penelitian & Pengabdian, 4(11), 10213–10230. https://doi.org/https://doi.org/10.58344/locus.v4i11.5015
Arifin, M. (2022). Metodologi Penelitian Kesehatan: Konsep, Desain, dan Aplikasi Statistika. Pustaka Ilmu.
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Virani, S. S., Williams, K. A., Yeboah, J., & Ziaeian, B. (2019). Guideline on the Primary Prevention of Cardiovascular Disease. American Heart Association, 140(11), e596–e646. https://doi.org/10.1161/CIR.0000000000000678
Asy’ary, Q., Wihastuti, T. A., & Ismail, D. D. S. L. (2024). Comparison of Sand Pillows and Cold Compresses in Reducing The Incidence of Hematoma in Post Percutaneous Coronary Intervention (PCI) Patients. Jurnal Health Sains, 5(5), 299–306. https://doi.org/https://doi.org/10.46799/jhs.v5i5.1266
Aziz, W. A. El, Fawzy, A., & Elkersh, A. (2025). Relation between Body Mass Index and Clinical Outcome after Percutaneous Coronary Intervention of Chronic Total Occlusion. The Egyptian Journal of Hospital Medicine, 100, 3929–3935. https://doi.org/10.21608/ejhm.2025.414138.1820
Banatvala, N., Akselrod, S., Bovet, P., & Mendis, S. (2023). The WHO Global Action Plan for the Prevention and Control of NCDs 2013-2030. Noncommunicable Diseases: A Compendium, 234–239. https://doi.org/10.4324/9781003306689-36
Bansal, A., & Hiwale, K. (2023). Updates in the Management of Coronary Artery Disease. Cureus, 15(12), 1–10. https://doi.org/10.7759/cureus.50644
Bazied, N., Mohammed, I., Aboelazayiem, H., & AbdElkhalik, E. (2022). Effect of Application Cold Compresses on Range of Motion, Activity Daily Living and Pain Control Among Patients with Total Knee Replacement. Minia Scientific Nursing Journal, 012(1), 159–169. https://doi.org/10.21608/msnj.2023.182625.1044
Beda, N. S., Situngkir, R., Sumua, L. S., & Pinulogod, J. J. (2024). Edukasi Kesehatan Terhadap Kecemasan Keluarga Dalam Pelaksanan Tindakan Invasif. Jurnal Sains, Teknologi Dan Kesehatan, 1(2), 104–113. https://doi.org/https://doi.org/10.62335/yvewc098
Bonnet, G., Rommel, K.-P., Falah, B., Lansky, A. J., & Zhang, Y. (2025). Impact of Mean Blood Pressure Profiles in Percutaneous Left Ventricular Assist Device Supported High Risk Percutaneous Coronary Intervention. Journal of the American Heart Association, 14(10), 1–12. https://doi.org/10.1161/JAHA.124.036367
British Heart Foundation. (2024). Global heart & circulatory diseases factsheet. British Heart Foundation, Januari, 1–12.
Buldak, C. İ., & Çınar, F. İ. (2024). Effects of cold application before subcutaneous injection of low-molecular-weight heparin on pain , bruising , and hematoma formation. Gulhane Medical Journal, 66(3), 121–127. https://doi.org/10.4274/gulhane.galenos.2024.62533
Chen, J., Wen, Y., Jin, L., Peng, J., & Ji, J. (2022). Effect of Clinical Nursing Pathway Intervention Based on Evidence-Based Medicine on Venous Thrombosis in Long-Term Bedridden Patients. Journal of Healthcare Engineering. https://doi.org/https://doi.org/10.1155/2022/5120569
Creswell, J. W., & Creswell, J. D. (2021). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. SAGE Publication.
Doll, J. A., Hira, R. S., Kearney, K. E., Kandzari, D. E., Riley, R. F., Marso, S. P., Grantham, J. A., Thompson, C. A., McCabe, J. M., Karmpaliotis, D., Kirtane, A. J., & Lombardi, W. (2020). Management of Percutaneous Coronary Intervention Complications: Algorithms from the 2018 and 2019 Seattle Percutaneous Coronary Intervention Complications Conference. American Heart Association, 13(6), 1–10. https://doi.org/https://doi.org/10.1161/CIRCINTERVENTIONS.120.008962
Fadhilah, I. N., Melastuti, E., & Amal, A. I. (2023). Efektivitas Kombinasi Cold Pack Dan Stepty P Terhadap Kejadian Hematoma Pada Pasien Post Coronary Angiography (CAG) Di Rsi Sultan Agung Semarang.
Fawwaz, S. M., & Pardede, D. K. B. (2023). Dampak Kebiasaan Merokok terhadap Risiko Anestesi dan Pembedahan. General Medicine, 50(10), 576–580. https://doi.org/https://doi.org/10.55175/cdk.v50i10.928
Galli, M., Laborante, R., Andreotti, F., Vergallo, R., Montone, R. A., Iaconelli, A., Trani, C., Burzotta, F., Crea, F., & D’Amario, D. (2022). Bleeding Complications in Patients Undergoing Percutaneous Coronary Intervention. Reviews in Cardiovascular Medicine, 23(8). https://doi.org/10.31083/j.rcm2308286
Handayani, D. P., Imamah, I. N., & Indrastuti, Y. (2024). Penerapan Kompres Ice Gel Pack untuk Penurunan Nyeri Pasien Pasca Operasi Fraktur. Antigen : Jurnal Kesehatan Masyarakat Dan Ilmu Gizi, 2(3), 65–95. https://doi.org/10.57213/antigen.v2i3.306
Hanna, J. M., Wang, S. Y., Kochar, A., Park, D. Y., Damluji, A. A., Henry, G. A., Ahmad, Y., Curtis, J. P., & Nanna, M. G. (2023). Complex Percutaneous Coronary Intervention Outcomes in Older Adults. Journal of the American Heart Association, 12(19), 1–12. https://doi.org/10.1161/JAHA.122.029057
Hartley, A., & Nijjer, S. (2022). Percutaneous Coronary Intervention. European Journal of Medical and Health Sciences, 4(4), 233–248. https://doi.org/10.1007/978-3-031-09815-4_13
Henein, M. Y., Vancheri, S., Longo, G., & Vancheri, F. (2022). The Impact of Mental Stress on Cardiovascular Health. Journal of Clinical Medicineical Medicine, Cv. https://doi.org/10.3390/jcm11154405
Hyder, A. A., Rylance, S., Al Saegh, A., Feigin, V. L., Kataria, I., Laatikainen, T., Lee, L., Mahendradhata, Y., Marten, R., Mikkelsen, B., Miranda, J. J., Nugent, R., Owolabi, M., Sullivan, R., Virani, S. S., & Reddy, K. S. (2023). Strengthening evidence to inform health systems: Opportunities for the WHO and partners to accelerate progress on non-communicable diseases. BMJ Global Health, 8(11), 1–4. https://doi.org/10.1136/bmjgh-2023-013994
Kareem, H. M., & Al-kassar, R. A. H. (2023). Effect of Direct Cold Compress for Femoral Arterial Sheath Removal on Reduction of Local Vascular Complications in Patients after Percutaneous Coronary Intervention. Kufa Journal for Nursing Sciences, 13(2), 99–110. https://doi.org/https://doi.org/10.36321/kjns.vi20232.12477
Kemenkes RI. (2021). Profil Kesehatan Indonesia 2021. Kemenkes RI.
Kim, H. (2024). Sex differences in coronary atherogenesis. Ewha Medical Journal, 47(2), 1–9. https://doi.org/https://doi.org/10.12771/emj.2024.e15
Korkmaz, E., & Karagözoğlu, Ş. (2022). Comparison of Sandbag, Close Pad, and Cold Application Combined with Sandbag in Preventing Peripheral Vascular Complications After Cardiac Catheterisation. Cumhuriyet Medical Journal, 44(2), 150–158. https://doi.org/http://dx.doi.org/10.7197/cmj.1053991
Kurt, Y., & Kasikci, M. (2019). The effect of the application of cold on hematoma, ecchymosis, and pain at the catheter site in patients undergoing percutaneous coronary intervention. International Journal of Nursing Sciences, 6, 378–384. https://doi.org/10.1016/j.ijnss.2019.09.005
Kwak, E. S., Shah, M., Alharbi, A., Bansal, N., & Qafisheh, Q. (2025). The Influence of Body Mass Index on Percutaneous Coronary Intervention Outcomes. MDPI, 6(5), 1–10. https://doi.org/https://doi.org/10.3390/hearts6010005
Lutfiah, A., & Mustika, A. (2025). Prevalensi dan Profil Penderita Sindroma Koroner Akut dengan ST Segmen Elevasi (STEMI) di Rumah Sakit Umum Daerah dr. Fauziah Bireuen Tahun 2022-2023. Protein: Jurnal Ilmu Keperawatan Dan Kebidanan, 3(3). https://doi.org/https://doi.org/10.61132/protein.v3i3.1598
Mohamed, A. B., Ahmed, T. A.-H. N., & Mehany, M. M. (2025). Effect of Implementing Nursing Guidelines on Improving Local Vascular Outcomes among Patients Undergoing Primary Percutaneous Coronary Intervention. The Malaysian Journal Of Nursing, 17(1), 210–221. https://doi.org/10.31674/mjn.2025.v17i01.022
Ndrepepa, G., Kufner, S., Cassese, S., Joner, M., Xhepa, E., Sager, H. B., Schunkert, H., & Kastrati, A. (2025). Body Mass Index and 10-Year Clinical Outcomes After Percutaneous Coronary Intervention — Interaction with Age , Sex , Diabetic Status and Clinical Presentation. Journal of Clinical Medicine, 14(1413), 1–15. https://doi.org/https://doi.org/ 10.3390/jcm14051413
NICE Guideline. (2023). Cardiovascular disease: risk assessment and reduction, including lipid modification. In NICE Guidance CG238.
Nuraeni, A., Arrafi, A. R., Rahmah, A., Rohaeti, E., Adzillah, F. L. N., Arafah, H. N., Assafa, M. I., Merdekawati, R., Amalia, R. N., Riskyani, U., Ramadhani, V. D., Sugiharto, F., Emaliyawati, E., & Mirwanti, R. (2023). Potensi Kompres Dingin Terhadap Pencegahan Hematoma pada Pasien Pasca Percutaneous Coronary Intervention. Malahayati Nursing Journal, 5(7), 2185–2200. https://doi.org/10.33024/mnj.v5i7.9996
Ozkan, B., & Cavdar, I. (2021). The Effect of Cold Therapy Applied to the Incision Area After Abdominal Surgery on Postoperative Pain and Analgesic Use. Pain Management Nursing, 22(6), 775–782. https://doi.org/10.1016/j.pmn.2021.03.007
Pamuk, G. D., & Özkaraman, A. (2024). The Effect of Cold Sand Pack on Percutaneous Coronary Intervention-Induced Vascular Complications and Pain. Florence Nightingale Journal of Nursing, 32(1), 58–67. https://doi.org/10.5152/FNJN.2024.23074
Park, S., Wilkens, L. R., Murphy, S. P., Monroe, K. R., Henderson, B. E., & Kolonel, L. N. (2021). Body mass index and mortality in an ethnically diverse population. National Library of Medicice, 27(7), 489–497. https://doi.org/10.1007/s10654-012-9695-5.Body
Pascayantri, A., Malik, F., Hudriah, A., & Juanti, P. (2025). Faktor Penentu Hipertensi Tidak Terkontrol dan Implikasinya terhadap Strategi Pencegahan Berbasis Populasi. Lansau: Jurnal Ilmu Kefarmasian, 3(2), 76–92. https://doi.org/10.33772/lansau.v3i2.45
Patil, H., Hesarur, V., & Mahanta, S. (2025). A Study to Assess the Effectiveness of Cryotherapy in Preventing Hematoma at the Arterial Puncture Site Among Post-percutaneous Coronary Intervention ( PCI ) Patients in a Selected Tertiary Care Hospital , Belagavi. Cureus, 17(3). https://doi.org/10.7759/cureus.80921
Pinxterhuis, T. H., Ploumen, E. H., Zocca, P., Doggen, C. J. M., Schotborgh, C. E., Anthonio, R. L., Roguin, A., Danse, P. W., Benit, E., Aminian, A., Stoel, M. G., Linssen, G. C. M., Geelkerken, R. H., & von Birgelen, C. (2023). Risk of bleeding after percutaneous coronary intervention and its impact on further adverse events in clinical trial participants with comorbid peripheral arterial disease. International Journal of Cardiology, 374(December 2022), 27–32. https://doi.org/10.1016/j.ijcard.2022.12.009
Prasetya, A., & Handian, F. I. (2023). The effect of ice gel pack on pain reduction of sheath removal in post-cardiac catheterization patients. The Journal of Palembang Nursing Studies, 2(1), 67–74. https://doi.org/10.55048/jpns.v2i1.79
Pristya, I. Y., Nurachmah, E., & Maria, R. (2025). Effectiveness Of Cold Compress In Preventing Hematoma In Post Percutaneous Coronary Intervention (PCI) Patients. Indonesian Journal of Global Health Research, 7(2), 1165–1172. https://doi.org/https://doi.org/10.37287/ijghr.v7i2.5807
Purwoko, R. Y., Asmail, A., Tambing, C. P., Nusasenjaya, R., & Suprayogi, A. (2025). Kepatuhan Pasca-Operasi Jantung: Tinjauan Literatur Sistematis Mengenai Faktor Penentu pada Populasi Militer dan Sipil. Jurnal Kesehatan Indonesia - Research Dan Practice, 1–13.
Reynolds, C. A., & Minic, Z. (2023). Chronic Pain-Associated Cardiovascular Disease : The Role of Sympathetic Nerve Activity. Internasional Journal of Molecular Sciences. https://doi.org/10.3390/ijms24065378
Seweid, M. M., Ahmed, N. T., Ramadan, B. A., & Ahmed, F. R. (2021). International Journal of Africa Nursing Sciences Effect of cold application on incisional pain associated with incentive spirometry after coronary artery bypass graft surgery. International Journal of Africa Nursing Sciences, 15, 100315. https://doi.org/10.1016/j.ijans.2021.100315
Sobh, H. R., Shereif, W. I., Mohammed, H. A. B., & Salama, M. K. E. E. (2021). Effect of Nursing Intervention on Prevention of Vascular access Complications for Patients undergoing Regular Hemodialysis. International Journal of Novel Research in Healthcare and Nursing, September.
Sugiharto, F., Nuraeni, A., Trisyani, Y., & Melati, A. (2024). Nursing interventions for improving quality of life among patients with coronary heart disease after percutaneous coronary intervention. Jurnal Keperawatan Padjadjaran, 12(1). https://doi.org/http://dx.doi.org/10.24198/jkp. v12i1.2294
Sugiyono. (2018). Metode Penelitian Kuantitatif, Kualitatif, dan R&D. Alfabeta.
Suhanda, S., Putri, S. Y. S., & Setiawan, H. (2023). Coldpack Intervention to Alleviate Hematoma in Post-Percutaneous Coronary Intervention Patient. Genius Journal, 4(2), 363–375. https://doi.org/10.56359/gj.v4i2.311
Valikhani, M., Mahdizadeh, S. M., Eshraghi, A., Mazlum, S. R., & Dehghani, J. (2020). The Effect of Simultaneous Sand-Ice Bag Application on Hemorrhage and Hematoma after Percutaneous Coronary Intervention. Journal of Caring Sciences As, 9(4), 188–194. https://doi.org/10.15171/jcvtr.2015.24
Visseren, F., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J. M., Capodanno, D., Cosyns, B., Crawford, C. A., Davos, C. H., Desormais, I., Di Angelantonio, E., Duran, O. H. F., Halvorsen, S., Richard Hobbs, F. D., Hollander, M., … Mullabayeva, G. (2021). Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 42(34), 3227–3337. https://doi.org/10.1093/eurheartj/ehab484
WHO. (2021). Cardiovascular Diseases. WHO.
Widodo, W., Fajarini, M., & Jumaiyah, W. (2023). Aplikasi Cold Pack Penurunan Nyeri Pasca Kateterisas Jantung. Jurnal Keperawatan, 15, 95–102. https://doi.org/https://doi.org/10.32583/keperawatan.v15i1.167
Yassen, N. A., El-Far, A. F., Elmasry, M. M., & Diab, S. M. (2025). Effect of Physical Counter Pressure Maneuvers during Femoral Sheath Removal on Adverse Events Post Cardiac Catheterization. Tanta Scientific Nursing Journal, 36(1). https://doi.org/10.21608/tsnj.2025.424748
Zhang, T., & Qi, X. (2021). Greater Nursing Role for Enhanced Post-Percutaneous Coronary Intervention Management. International Journal of General Medicine, 7115–7120. https://doi.org/:10.2147/IJGM.S337385
Zhi, G., Lei, M., Qian, S., Li, Y., Zhao, Z., & Xue, Z. (2024). Nursing of forearm hematoma after transradial coronary intervention. February. https://doi.org/10.1002/hsr2.70050
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
