title: Risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a matched case-control study.
abstract: BACKGROUND
  Side effects of the medications used for procedural sedation and analgesia in the cardiac catheterisation laboratory are known to cause impaired respiratory function. Impaired respiratory function poses considerable risk to patient safety as it can lead to inadequate oxygenation. Having knowledge about the conditions that predict impaired respiratory function prior to the procedure would enable nurses to identify at-risk patients and selectively implement intensive respiratory monitoring. This would reduce the possibility of inadequate oxygenation occurring.
  
  
  OBJECTIVE
  To identify pre-procedure risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory.
  
  
  METHODS
  Retrospective matched case-control.
  
  
  METHODS
  21 cases of impaired respiratory function were identified and matched to 113 controls from a consecutive cohort of patients over 18 years of age. Conditional logistic regression was used to identify risk factors for impaired respiratory function.
  
  
  RESULTS
  With each additional indicator of acute illness, case patients were nearly two times more likely than their controls to experience impaired respiratory function (OR 1.78; 95% CI 1.19-2.67; p = 0.005). Indicators of acute illness included emergency admission, being transferred from a critical care unit for the procedure or requiring respiratory or haemodynamic support in the lead up to the procedure.
  
  
  CONCLUSIONS
  Several factors that predict the likelihood of impaired respiratory function were identified. The results from this study could be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory.
authors.affiliation: School of Nursing, Midwifery and Paramedicine (QLD), Australian Catholic University, Australia. awconw001@myacu.edu.au
authors.forename: Aaron
authors.initials: A
authors.lastname: Conway
authors.forename: Karen
authors.initials: K
authors.lastname: Page
authors.forename: John
authors.initials: J
authors.lastname: Rolley
authors.forename: Paul
authors.initials: P
authors.lastname: Fulbrook
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000451:nursing*; D016022:Case-Control Studies; D016292:Procedural Sedation / Q000009:adverse effects* / Q000451:nursing; D054810:Deep Sedation / Q000009:adverse effects* / Q000451:nursing; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000209:etiology* / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D025341:Principal Component Analysis; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006993:Hypnotics and Sedatives