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Invited Critique
Sep 2011

Effect of Sleep Deprivation on Patient Safety: New Awakening or Tired Argument?Comment on “Prospective Evaluation of Consultant Surgeon Sleep Deprivation and Outcomes in More Than 4000 Consecutive Cardiac Surgical Procedures”

Author Affiliations

Author Affiliation: Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland.

Arch Surg. 2011;146(9):1085. doi:10.1001/archsurg.2011.120

Academic traditionalists in the cardiac surgical community are presently going through the 5 Kubler-Ross stages of grief in dealing with the residency work-hour restrictions imposed by the ACGME. Because this patient safety measure is largely based on the notion that tired and sleep-deprived physicians and surgeons are more prone to error, this study1 represents an excellent attempt at determining whether fatigue compromises the technical performance and patient outcomes in the demanding discipline of cardiothoracic surgery. The authors cogently hypothesize that the maintenance of good outcomes under these circumstances might be attributed to the “team sport” character of cardiac surgery and “burned-in” cognitive and technical skills and physiologic conditioning of consultant surgeons.

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