Australian critical care : official journal of the Confederation of Australian Critical Care Nurses · 2026
Efficacy and safety of drinking ice-carbonated water and ice-purified water immediately after extubation in paediatric patients with congenital heart disease: A randomised, controlled three-arm trial.
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Zhang Xuecui, Chen Yaqin, Peng Yanchun, Li Sailan, Chen Liangwan, Lin Yanjuan
Аннотация
BACKGROUND: Children who undergo congenital heart disease (CHD) surgery face increased postoperative thirst, which can cause discomfort and lead to serious consequences. There is a lack of effective thirst management strategies for this vulnerable group.
OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of ice-carbonated water and ice-purified water in alleviating thirst in children following CHD surgery.
METHODS: A randomized controlled trial with three parallel arms was conducted at a tertiary medical center in China between August and December 2022. A total of 108 children aged 3-12 years who had undergone congenital heart disease surgery and were conscious with a thirst numeric rating scale (NRS) score ≥3 were included in the study. Participants were randomly assigned to drink ice-carbonated water (H2O-ice-carb group), ice-purified water (H2O-ice group), or receive conventional care (control group). Interventions were administered five times: immediately after extubation following the assessment of the safety protocol for paediatric thirst management, and then at 1, 2, 3, and 4 hours post-extubation. Outcomes were assessed at six time points: T0 (baseline, immediately after extubation, prior to the safety protocol for paediatric thirst management assessment and any intervention) and T1-T5 (after each of the five interventions). Primary outcomes were NRS scores for thirst and oral moisture, while secondary outcomes included oral comfort, saliva pH, and adverse events.
RESULTS: A generalised estimating equation analysis demonstrated group-by-time interactions for both primary outcomes. At T5, the between-group difference in thirst NRS was -4.71 points (95% confidence interval [CI]: -5.12 to -4.30) for H2O-ice-carb group vs. control group and -3.86 points (95% CI: -4.36 to -3.35) for H2O-ice group vs. control group (both P < 0.001). The H2O-ice-carb group demonstrated greater improvement than the H2O-ice group (difference = -0.85; 95% CI: -1.26 to -0.44; P < 0.001), with the difference apparent from T1 (P = 0.009). For oral moisture, the H2O-ice-carb group showed the strongest effect (2.51% per hour), followed by the H2O-ice group (1.66% per hour; both P < 0.001). No differences in adverse events were found among the three groups (P = 0.364).
CONCLUSIONS: Immediate consumption of ice-carbonated and ice-purified water following extubation effectively and safely alleviates postoperative thirst in children after CHD surgery, with ice-carbonated water showing better results. These findings may inform the development of postoperative fasting and fluid management protocols for paediatric patients.
OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of ice-carbonated water and ice-purified water in alleviating thirst in children following CHD surgery.
METHODS: A randomized controlled trial with three parallel arms was conducted at a tertiary medical center in China between August and December 2022. A total of 108 children aged 3-12 years who had undergone congenital heart disease surgery and were conscious with a thirst numeric rating scale (NRS) score ≥3 were included in the study. Participants were randomly assigned to drink ice-carbonated water (H2O-ice-carb group), ice-purified water (H2O-ice group), or receive conventional care (control group). Interventions were administered five times: immediately after extubation following the assessment of the safety protocol for paediatric thirst management, and then at 1, 2, 3, and 4 hours post-extubation. Outcomes were assessed at six time points: T0 (baseline, immediately after extubation, prior to the safety protocol for paediatric thirst management assessment and any intervention) and T1-T5 (after each of the five interventions). Primary outcomes were NRS scores for thirst and oral moisture, while secondary outcomes included oral comfort, saliva pH, and adverse events.
RESULTS: A generalised estimating equation analysis demonstrated group-by-time interactions for both primary outcomes. At T5, the between-group difference in thirst NRS was -4.71 points (95% confidence interval [CI]: -5.12 to -4.30) for H2O-ice-carb group vs. control group and -3.86 points (95% CI: -4.36 to -3.35) for H2O-ice group vs. control group (both P < 0.001). The H2O-ice-carb group demonstrated greater improvement than the H2O-ice group (difference = -0.85; 95% CI: -1.26 to -0.44; P < 0.001), with the difference apparent from T1 (P = 0.009). For oral moisture, the H2O-ice-carb group showed the strongest effect (2.51% per hour), followed by the H2O-ice group (1.66% per hour; both P < 0.001). No differences in adverse events were found among the three groups (P = 0.364).
CONCLUSIONS: Immediate consumption of ice-carbonated and ice-purified water following extubation effectively and safely alleviates postoperative thirst in children after CHD surgery, with ice-carbonated water showing better results. These findings may inform the development of postoperative fasting and fluid management protocols for paediatric patients.