The efficacy of earplugs and eye masks for delirium severity and sleep quality in patients undergoing coronary artery bypass grafting in cardiac intensive care units: A single-blind, randomised controlled trial

Shorofi, Seyed Afshin; Dadashian, Pooneh; Arbon, Paul; Moosazadeh, Mahmood

doi:10.1016/j.aucc.2023.08.003

Cited by 7 publications

(3 citation statements)

References 81 publications

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“…In one single-blind, randomized controlled trial on 114 patients who underwent CABG, patients were randomized to routine care plus eye masks and earplugs during nighttime as compared to patients who received only routine postoperative care. The severity of POD was significantly reduced in the experimental group, while having positive effects on overall sleep quality [58].…”

Section: Postoperative Interventionsmentioning

confidence: 83%

Delirium after Cardiac Surgery—A Narrative Review

Mattimore,

Fischl,

Christophides

et al. 2023

Brain Sciences

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Postoperative delirium (POD) after cardiac surgery is a well-known phenomenon which carries a higher risk of morbidity and mortality. Multiple patient-specific risk factors and pathophysiologic mechanisms have been identified and therapies have been proposed to mitigate risk of delirium development postoperatively. Notably, cardiac surgery frequently involves the use of an intraoperative cardiopulmonary bypass (CPB), which may contribute to the mechanisms responsible for POD. Despite our greater understanding of these causative factors, a substantial reduction in the incidence of POD remains high among cardiac surgical patients. Multiple therapeutic interventions have been implemented intraoperatively and postoperatively, many with conflicting results. This review article will highlight the incidence and impact of POD in cardiac surgical patients. It will describe some of the primary risk factors associated with POD, as well as anesthetic management and therapies postoperatively that may help to reduce delirium.

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Section: Postoperative Interventionsmentioning

confidence: 83%

Delirium after Cardiac Surgery—A Narrative Review

Mattimore,

Fischl,

Christophides

et al. 2023

Brain Sciences

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“…Sleep patterns change before the onset of delirium; thus, improving sleep quality in ICU patients can reduce delirium severity. 5 , 11 …”

Section: Introductionmentioning

confidence: 99%

“…Besides, SD is closely associated with other common ICU complications, such as delirium. Sleep patterns change before the onset of delirium; thus, improving sleep quality in ICU patients can reduce delirium severity 5,11 …”

Section: Introductionmentioning

confidence: 99%

Propofol improves sleep deprivation‐induced sleep structural and cognitive deficits via upregulating the BMAL1 expression and suppressing microglial M1 polarization

Liu,

Yang,

Wang

et al. 2024

CNS Neurosci Ther

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BackgroundSleep deprivation (SD) is a growing global health problem with many deleterious effects, such as cognitive impairment. Microglia activation‐induced neuroinflammation may be an essential factor in this. Propofol has been shown to clear sleep debt after SD in rats. This study aims to evaluate the effects of propofol‐induced sleep on ameliorating sleep quality impairment and cognitive decline after 48 h SD.MethodsAlmost 8–12‐week‐old rats were placed in the SD system for 48 h of natural sleep or continuous SD. Afterwards, rats received propofol (20 mg·kg−1·h−1, 6 h) via the tail or slept naturally. The Morris water maze (MWM) and Y‐maze test assessed spatial learning and memory abilities. Rat EEG/EMG monitored sleep. The expression of brain and muscle Arnt‐like protein 1 (BMAL1), brain‐derived neurotrophic factor (BDNF) in the hippocampus and BMAL1 in the hypothalamus were assessed by western blot. Enzyme‐linked immunosorbent assay detected IL‐6, IL‐1β, arginase 1 (Arg1), and IL‐10 levels in the hippocampus. Immunofluorescence was used to determine microglia expression as well as morphological changes.ResultsCompared to the control group, the sleep‐deprived rats showed poor cognitive performance on both the MWM test and the Y‐maze test, accompanied by disturbances in sleep structure, including increased total sleep time, and increased time spent and delta power in non‐rapid eye movement sleep. In addition, SD induces abnormal expression of the circadian rhythm protein BMAL1, activates microglia, and causes neuroinflammation and nerve damage. Propofol reversed these changes and saved sleep and cognitive impairment. Furthermore, propofol treatment significantly reduced hippocampal IL‐1β and IL‐6 levels, increased BDNF, Arg1, and IL‐10 levels, and switched microglia surface markers from the inflammatory M1 type to the anti‐inflammatory M2 type.ConclusionPropofol reduces SD‐induced cognitive impairment and circadian rhythm disruption, possibly by lowering neuronal inflammation and switching the microglia phenotype from an M1 to an M2 activated state, thus exerting neuroprotective effects.

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