Objective To determine the safety and efficacy of early postoperative mobilization in patients who have undergone surgical repair of acute type A aortic dissection. Design Randomized controlled trial. Setting Heart Medical Center. Subjects Seventy-seven patients with acute type A aortic dissection were assessed. Intervention Patients were randomly allocated into: (1) the control group (usual care) ( n  =  38) and (2) the intervention group (early goal-directed mobilization) ( n  =  39). Main Measures The primary outcome was the patient's functional status. The secondary outcomes included vital signs, serious adverse events, muscle strength, intensive care unit-acquired weakness, grip strength, duration of mechanical ventilation, length of stay, readmission rate, and health-related quality of life after 3 months. Results The vital signs of the patients were within the tolerable ranges during the entire intervention. No serious exercise-related adverse events were observed in the intervention group. The Barthel Index score ( P  =  0.013), Medical Research Council score ( P  =  0.001), grip strength ( P  =  0.001), and health-related quality of life ( P  =  0.001) were higher in the intervention group. Intensive care unit acquired weakness ( P  =  0.019), duration of mechanical ventilation ( P  =  0.002), intensive care unit stay ( P  =  0.002), and total length of stay ( P  =  0.010) were lower in the intervention group. Patients in the intervention group had a higher physical health-related quality of life ( P  =  0.015) at 3 months post-surgery. There was no difference in readmission rates. Conclusions Delivery of early goal-directed mobilization in acute type A aortic dissection was safe and facilitated the recovery of daily living ability, shorter hospital stay, and improved quality of life after discharge.

Background: Cardiac surgery patients are at a risk of postoperative nausea, vomiting, and aspiration pneumonia, but conventional 4–6-h fasting can exacerbate thirst. Early oral hydration is recommended, but the post-extubation time for intervention remains unclear. This study aimed to investigate the effects of early thirst management on thirst, the oral environment, gastrointestinal adverse reactions, and aspiration pneumonia in cardiac surgery patients.Methods: A total of 84 cardiac surgery patients were randomly divided into two groups for either conventional oral hydration or early oral hydration. The primary outcome was thirst intensity. The secondary outcomes were adverse gastrointestinal reactions (nausea and vomiting), aspiration pneumonia, unstimulated saliva flow rates, salivary pH, oral odor, oral mucosal moisture, and patients' satisfaction. At 1 h post-extubation, patients were evaluated for thirst intensity and intervention readiness. Patients who passed the evaluation were subjected to thirst management. Results: The patient demographic and clinical characteristics did not significantly vary between the groups. The scores for thirst (3.38 versus 8.24，F=306.21, P＜0.001), oral mucosa (2.03 versus 3.90, P＜0.001), halitosis (2.77 versus 3.76, P＜0.001) were significantly lower in the early oral hydration group than in the conventional oral hydration group. The early oral hydration group was associated with significantly higher salivary pH (6.44 versus 0, P＜0.001), unstimulated saliva flow rates (0.18 versus 0, P＜0.001) and patient satisfaction (4.28 versus 3.15, P＜0.001) than the conventional oral hydration group. Gastrointestinal adverse reactions did not significantly vary (7.70% versus 4.88%, P=0.60), and aspiration pneumonia was not observed in both groups.Conclusion: The early oral hydration significantly alleviated thirst, stabilized the oral environment without exacerbating gastrointestinal adverse reactions and aspiration pneumonia, and increased patient satisfaction.Trial registration: Chinese Clinical Trial Registry: ChiCTR2100049206. Registered 25 July 2021.