The Correlation Between Sleep Quality and Atrial Fibrillation Undergoing High-flow Nasal Cannula Oxygen (HFNC)
- Conditions
- Hypoxemia
- Interventions
- Device: heated humidified high-flow nasal cannulaDevice: noninvasive ventilation
- Registration Number
- NCT02713737
- Lead Sponsor
- Henan Institute of Cardiovascular Epidemiology
- Brief Summary
The investigators hypothesized that heated humidified high-flow nasal cannula oxygen(HFNC) along with high quality of sleep, in comparison with noninvasive positive pressure ventilation (NIV), could reduce the release of inflammatory marker C-reactive protein(CRP), which as independent predictor of atrial fibrillation（AF）, further lower the incidence of new-onset AF following coronary artery bypass grafting(CABG).
- Detailed Description
Atrial fibrillation (AF) has been reported to occur in up to 20-40% of patients undergoing coronary artery bypass grafting (CABG). Postoperative AF plays a major role in the determination of hemodynamic deterioration and can be associated with thromboembolic stroke. Aside from the risk factors of age, pain, cardiac dysfunction and hypokalemia, hypoxemia is also considered to be the major contributor to AF initiation and persistence. Aiming to the common postoperative complications, noninvasive positive pressure ventilation (NIV) provides an available modality to improve the oxygen and even obviate the reintubation.
However, some patients are contraindications for NIV, with Loss of consciousness, hemodynamic instability, and some are intolerance due to dryness, gastric distension, skin breakdown and noise, with complaints of insomnia and sleep disturbance. The aforementioned factors largely limits its use. Recently, the heated humidified high-flow nasal cannula (HFNC), free of psychic stress and physical discomfort, shows a favorable compliance and tolerance in treating the hypoxemic patients. As a result, in this comfortable setting we predict a high sleep quality in HFNC oxygen therapy. Evidence has suggested that sleep abnormalities trigger the cascaded release of C-reactive protein (CRP). As is well known that CRP is involved in atrial structural remodeling and asynchronous conduction, which attribute to the initiation and maintenance of AF.
Therefore, in this present study, the investigators first evaluate the sleep quality (architecture and duration) by the polysomnographic (PSG) monitoring after coronary surgery. Based on the sleep parameters, the investigators hypothesize that HFNC, along with high quality of sleep, in comparison with NIV, could reduce the release of C-reactive protein, which as independent predictor of atrial fibrillation (AF), further lower the incidence of new-onset AF following CABG.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 80
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description HFNC group heated humidified high-flow nasal cannula HFNC: Heated humidified high-flow nasal cannula. NIV group noninvasive ventilation NIV: Noninvasive ventilation.
- Primary Outcome Measures
Name Time Method Incidence of atrial fibrillation 10 days from ICU admission to discharge
- Secondary Outcome Measures
Name Time Method total sleep time 48 hours The duration from 8 in the evening to 8 in the morning within the first 2 days after surgery.
inotropic usage 5 days from ICU admission to discharge
rapid eye movement (REM) sleep (%) 48 hours The duration from 8 in the evening to 8 in the morning within the first 2 days after surgery.
PO2/FiO2(P/F) 5 days from ICU admission to discharge
Lactate levels 5 days from ICU admission to discharge
intubation time 5 days from intubation in the operating room to discharge
transfusion requirement 5 days from ICU admission to discharge
arousal index 48 hours The duration from 8 in the evening to 8 in the morning within the first 2 days after surgery.
Trial Locations
- Locations (1)
Henan Provincial People' Hospital
🇨🇳Zhengzhou, Henan, China