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BackgroundModerate sedation is performed frequently in the hospital setting for same-day, invasive procedures. The primary administrators of moderate sedation are nurses who have been trained to administer medication based on patient responsiveness, airway, ventilation and cardiovascular function. This study evaluated the safety and efficacy of nurse-administered conscious sedation by assessing medication use, clinical outcomes and patient satisfaction.MethodsData from same-day, elective procedures in the cardiac catheterisation laboratory and interventional radiology departments were collected, including comorbidities, procedural characteristics and post-sedation questionnaires.ResultsProcedure duration was found to be longer in the cardiac catheterisation laboratory (55 minutes; interquartile range: 37–81 minutes) than in interventional radiology (24 minutes; interquartile range 16–45 minutes; Pvalue of <0.001). Associated comorbidities in the cardiac catheterisation laboratory compared to interventional radiology included hypertension in 103 patients (78% vs 44.7%, P=<0.001), heart failure in 23 patients (17.4% vs 3.2%, P=<0.001), arrhythmias in 20 patients (15.2% vs 1%, P=0.1), and chronic kidney disease in 44 patients (33.3% vs 14.9%, P=0.002).Conclusions:Patients receiving conscious sedation while undergoing procedures in the cardiac catheterisation laboratory and interventional radiology were found to have no adverse clinical outcomes, as evidenced by the absence of reversal agents and advanced airway requirements. The procedural duration of the catheterisation procedures were significantly longer than interventional radiology and patients received overall less sedation medication.

Introduction:Limited data exist on the association between suppression of tumorigenicity 2 (ST2) levels and recurrent hospitalizations and emergency department (ED) visits in ambulatory patients with heart failure (HF). In addition, race-specific data are scarce.Hypothesis:To evaluate the association of ST2 with (1) all-cause, cardiovascular, and HF-related hospitalization and ED visit rates and (2) death or HF hospitalization in outpatients with HF in a racially diverse population.Methods:We evaluated 307 outpatients with HF participating in a prospective cohort study in Atlanta, GA. ST2 was measured with a commercially available ELISA. Median follow-up was 3.1 years.Results:Mean age was 57?12 years, 64.2% were men, 51.5% Caucasian and 45.6% African-American, 26.7% in NYHA class III-IV. Median ejection fraction (EF) was 35% (60.3% had EF <40%); median BNP was 162 ng/mL; 41.4% had ischemic heart disease, and 33.6% had diabetes. Elevated (>35 ng/mL) ST2 was associated with 1.5- to 4-fold higher recurrent event rates, driven by HF events, Table 1. ST2 >35 ng/mL was associated with higher risk for death or HF hospitalization, met by 109 patients (3-year estimate: 35.4%; 44 deaths, 7 transplants, 4 ventricular assist devices, and 54 HF admissions); the adjusted HR was 2.28; 95%CI 1.38 to 3.78; P=0.001), Fig. 1. The risk was 5-fold higher in the first 6 months but declined gradually. There was no interaction between ST2 and gender or race for outcomes.Conclusions:Elevated ST2 levels among outpatients with HF are associated with 2-fold higher risk for death or HF hospitalization, which is higher in the first 6 months, and more healthcare resources utilization regardless of gender or race.