Immediate "sipping" vs. delayed oral fluid intake after extubation: A randomized controlled trial.

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2025-08-07 DOI:10.1016/j.jcrc.2025.155212

Šárka Sedláčková, Věra Nigrovičová, Monika Pecková, Miroslav Durila

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引用次数: 0

Abstract

Purpose: Despite advances in perioperative care, delayed oral fluid intake after extubation remains common and is often based on tradition rather than evidence. This study aimed to evaluate whether immediate oral fluid intake "sipping" after extubation reduces thirst and discomfort and is safe in an intensive care setting.

Methods: In this single-center, prospective, randomized controlled trial, 160 ICU patients who met extubation criteria were randomized 1:1 to either delayed fluid intake (2 h post-extubation) or immediate sipping (up to 3 ml/kg over 2 h). Thirst, discomfort, and adverse effects (nausea, vomiting, aspiration) were assessed at 0, 5, 30, 60, 90, and 120 min. Thirst relief was also evaluated in the experimental group. Statistical significance was set at p < 0.05.

Results: At 120 min, 64 of 80 patients in each group (80 %; 95 % CI: 70-88 %) reported thirst. The difference between groups was 0.0 % (95 % CI: -12 % to 12 %; p = 1.000). However, thirst relief between baseline and 120 min was observed in 11.3 % of patients in the sipping group (95 % CI: 5-20 %) vs. 1.3 % in the standard group (95 % CI: 0-7 %), with a difference of 10 % (95 % CI: 1-19 %; p = 0.0338). At 90 min, throat discomfort was present in 23.8 % of the sipping group (95 % CI: 15-35 %) vs. 42.5 % in the standard group (95 % CI: 32-54 %), with a difference of -18.7 % (95 % CI: -34 % to -3 %; p = 0.0118). Adverse effects (nausea, vomiting) were rare and comparable; no aspiration events were observed.

Conclusion: Immediate oral fluid intake "sipping"after extubation appears to be safe, improves thirst relief, and reduces discomfort in ICU patients without increasing adverse effects. These findings challenge traditional fasting practices and support early rehydration in post-extubation care.

Trial registration: The trial was registered at ClinicalTrials.gov on January 6, 2023 (Identifier: NCT05819645).

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拔管后立即“啜饮”vs.延迟口服液体摄入：一项随机对照试验。

目的：尽管围手术期护理取得了进展，拔管后延迟口服液体摄入仍然很常见，而且往往是基于传统而不是证据。本研究旨在评估拔管后立即口服液体“啜饮”是否能减少口渴和不适，以及在重症监护环境中是否安全。方法：在这项单中心、前瞻性、随机对照试验中，160例符合拔管标准的ICU患者按1:1的比例随机分为延迟补液组（拔管后2小时）和立即补液组（2小时内补液量为3ml /kg）。在0、5、30、60、90和120分钟时评估口渴、不适和不良反应（恶心、呕吐、误吸）。实验组的口渴缓解情况也进行了评估。结果：120min时，两组80例患者中64例(80%；95% CI: 70- 88%)报告口渴。组间差异为0.0% (95% CI: - 12% ~ 12%；p = 1.000)。然而，在基线和120分钟之间，饮用组中11.3%的患者口渴缓解（95% CI: 5- 20%），而标准组中为1.3% (95% CI: 0- 7%)，差异为10% (95% CI: 1- 19%；p = 0.0338)。在90分钟时，咽喉部不适的发生率为23.8% (95% CI: 15- 35%)，而标准组为42.5% (95% CI: 32- 54%)，差异为- 18.7% (95% CI: - 34%至- 3%；p = 0.0118)。不良反应（恶心、呕吐）罕见且具有可比性；未观察到误吸事件。结论：拔管后立即口服液体“啜饮”似乎是安全的，可以改善口渴缓解，减少ICU患者的不适，而不会增加不良反应。这些发现挑战了传统的禁食做法，并支持拔管后护理的早期补液。试验注册：该试验于2023年1月6日在ClinicalTrials.gov注册（标识符：NCT05819645）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.