Abstract 13586: Early Initiation of Oral Intake in Adult Patients After Cardiothoracic Surgery is Safe and Reduces Thirst: Results of a Randomized Clinical Trial
Aim: Tradition-based care dictates that patients fast for several hours post-cardiothoracic (CT) surgery due to concerns for adverse events (nausea, vomiting, dysphagia, aspiration pneumonia), although evidence is lacking to support this practice. Prolonged fasting causes patients significant distress from thirst. Our aim was to determine the effect of an early liberal regimen of ice chips and water on adverse events and thirst after CT surgery. We hypothesized that a liberal regimen vs. usual care (UC) would not increase adverse events and would reduce thirst. Method: We used a randomized controlled trial design with a sample of 149 patients from an 18-bed CTICU. Written informed consent was obtained and patients were randomized to UC (6-hour fast post-extubation) or liberal regimen during the pre-operative visit. After fasting 1 hour post-extubation, patients in the liberal regimen were first assessed with a 6-item protocol for oral intake readiness, and then offered ice chips. An hour later, they were advanced to water.
Results: The mean age was 66±12.4 years; 73.8% were male; 91.3% had coronary artery and/or valve surgery. The two groups were equivalent except for the post-operative mean dose of ketorolac that was higher in the UC group (p=.04). The table below shows no differences in nausea, vomiting, or dysphagia between the UC vs. liberal group, and no aspiration pneumonia. Complaints of high thirst levels 6 hours after extubation were greater in the UC group. In analysis adjusted for relevant demographic and clinical variables (logistic regression), patients in the liberal group were less likely to report high thirst levels, compared with UC patients (B=-.299, OR=.273, 95% CI .118-.630).
Conclusion: Early initiation of ice chips and water post-extubation after CT surgery was not associated with adverse events, but was associated with significantly less thirst. In appropriate patients, early oral intake can reduce thirst, a distressing symptom.
Author Disclosures: C. Ford: None. D. McCormick: None. W. Teng: None. J. Parkosewich: None.
- © 2015 by American Heart Association, Inc.