Oral Hydration 1 Hour After Extubation Is Safe And Effective In Cardiac Surgery Patients: A Randomized Trial

Abstract

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.