The Correlation Between Sleep Quality and Atrial Fibrillation Undergoing High-flow Nasal Cannula Oxygen (HFNC)
The Correlation Between Sleep Quality and Atrial Fibrillation Undergoing High-flow Nasal Cannula Oxygen (HFNC)
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).
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.
Inclusion criteria:

 Hypoxemic respiratory failure

 Exclusion criteria:

 Cardiac or respiratory arrest