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

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. 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 H 2 O-ice-carb group vs. control group and −3.86 points (95% CI: −4.36 to −3.35) for H 2 O-ice group vs. control group (both P < 0.001). The H 2 O-ice-carb group demonstrated greater improvement than the H 2 O-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 H 2 O-ice-carb group showed the strongest effect (2.51% per hour), followed by the H 2 O-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.