Thirst trajectory and influencing factors in children after surgery for congenital heart disease during ICU stay: A longitudinal study

Abstract

Objectives

In this study, we aimed to explore heterogeneous trajectories of thirst and to determine their influencing factors among children undergoing surgery for congenital heart disease during their stay in ICU.

Methods

We used a numerical rating scale to assess thirst intensity at five-time points: immediately and at 6 h, 12 h, 24 h, and 36 h after tracheal extubation. Latent class growth analysis was used to discern distinct categories of thirst trajectory, together with multiple logistic regression to investigate influencing factors.

Results

A cohort of 279 children completed the five-point follow-up. The overall thirst incidences at five-time points were 100%, 100%, 99.64%, 96.06%, and 76.34%, respectively, while the severe thirst incidences were 72.76%, 79.93%, 62.72%, 41.58%, and 21.50%, respectively. Thirst trajectories were categorized into three distinct groups: low-thirst–gradual-decline group (13.61%), high-thirst–rapid-decline group (46.60%), and high-thirst group (39.79%). Multiple logistic regression analysis showed that the vasoactive-inotropic score, sodium levels, fluid balance, oral fluid intake, oxygen flow after extubation, and mouth breathing were factors influencing thirst trajectories among children with congenital heart disease.

Conclusions

This study revealed that children with congenital heart disease experience enduring and profound thirst, and the thirst trajectory of postoperative children with congenital heart disease is heterogeneous during ICU admission.

Implications for clinical practice

Clinical medical staff should develop personalized thirst intervention measures tailored to the specific category of a child's thirst trajectory and the influencing factors at play.