Does sleep quality affects the immediate clinical outcome in patients undergoing coronary artery bypass grafting: A clinico-biochemical correlation

Abstract

Objective:Poor sleep quality is emerging as high prevalence among the patients suffering from cardiometabolic disturbances. The vascular polypeptide endothelin 1 (ET-1) is involved in many of the health disorders. However, its potential involvement in patients having poor sleep quality along with cardiovascular problem is limited. The present study was formulated to conduct a prospective analysis of the relationship between ET-1 and in hospital outcome in sleep disorder patients undergoing routine coronary artery bypass grafting (CABG).Methods:A total of 156 patients were enrolled and divided into two groups based on the Pittsburg Sleep Quality Index (PSQI) of ≤5 (Group I, n = 101) or >5 (Group II, n = 55). Blood sample was collected before anesthesia induction (ET-1a) and at 48 h (ET-1b) to analyze the plasma ET-1 and blood sugar level. The patients were monitored for any intraoperative adverse events and postoperative complications during their hospital stay.Results:Both groups were comparable in relation to age, sex, incidence of smoking and alcohol consumption. The distribution of comorbid conditions was also similar in both groups. The ET-1 level was higher in Group II than Group I before anesthesia induction as well as 48 h postoperatively (4.5 ± 1.75 vs. 10.61 ± 9.3, P = 0.001; 2.08 ± 1.3 vs. 8.3 ± 9.86, P = 0.0001, respectively). The Group II patients had a longer duration of mechanical ventilation (14.6 ± 12.05 vs. 10.1 ± 8.19, P = 0.001), Intensive Care Unit stay (2.08 ± 0.95 vs. 2.7 ± 1.45, P = 0016) and hospital stay (5.98 ± 1.73 vs. 7.8 ± 3.66, P = 0.0001, respectively). The high number of patients from Group II required inotrope and intra-aortic balloon pump support while compared with Group I (P ≤ 0.05 in each). The overall postoperative complication rate was significantly higher among patients with PSQI of >5 (Group II) except the rate of infection and neurological complications which was similar among both group of patients. The postoperative in hospital mortality was nil in Group I and 3.6% in Group II (P = 0.05). There was a strong relationship between PSQI and ET-1 at both the time points.Conclusion:Poor sleep quality associated with a higher incidence of adverse perioperative events in patients undergoing elective CABG. There exists a potential link between poor sleep quality and ET-1 in these groups of patients.

The Effects of Deep-Breathing Exercises on Postoperative Sleep Duration and Quality in Patients Undergoing Coronary Artery Bypass Graft (CABG): a Randomized Clinical Trial

“…1,25 Some studies have emphasized that poor sleep quality is associated with a higher occurrence of harmful preoperative events in patients undergoing CABG surgery. 26 A comprehensive evaluation of sleep problem is necessary for poor sleep management. 24 However, the effect of deep breathing Exercise on the sleep duration and quality in patients undergoing CABG is unclear.…”

Pharmacotherapy for improving postoperative sleep quality: a protocol for a systematic review and network meta-analysis

“…[1][2][3][4][5] Sleep disturbance, which is one of the most common aspects of severe postoperative discomfort, 6 is associated with delayed recovery, 7 postoperative pain, 8 postoperative cognitive dysfunction, 9 inflammatory response 10 and cardiac complications. 11 Therefore, improving the quality of sleep may promote the enhanced recovery of surgical patients. 12 Postoperative pain is believed to be one of the main causes of sleep disturbance.…”

Effect of Lavender Aromatherapy on Sleep Quality and Physiological Indicators in Patients after CABG Surgery: A Clinical Trial Study

“…5 Like other surgeries, CABG causes problems for patients including disturbances in sleep and physiological parameters. 6 , 7 …”