Cardiac Surgery, Postoperative Gastric Distension, Postoperative Gastrointestinal Dysfunction
Conditions
Keywords
Anti-Bloating Patch, Postoperative Gastric Distension, Gastric Bubble Area, Cardiac Surgery, Gastrointestinal Dysfunction
Brief summary
Postoperative gastric distension is a common gastrointestinal complication after cardiac surgery and may delay recovery, prolong intensive care unit (ICU) stay, and reduce patient comfort. Anti-bloating patches are widely used in clinical practice to promote gastrointestinal function recovery; however, high-quality evidence regarding their effectiveness in cardiac surgical patients remains limited. This randomized controlled trial aims to evaluate the efficacy and safety of an anti-bloating patch in reducing postoperative gastric distension after cardiac surgery. Adult patients undergoing cardiac surgery will be randomly assigned to receive either standard perioperative care alone or standard perioperative care plus anti-bloating patch therapy. Gastric bubble area will be quantitatively measured using chest radiographs and image analysis software. The primary outcome is the change in gastric bubble area on postoperative day 1 compared with baseline. Secondary outcomes include gastric bubble area on postoperative day 1, percentage change in gastric bubble area, abdominal distension score, time to first flatus, time to first bowel movement, gastric drainage volume, time to oral feeding, ICU length of stay, postoperative hospital length of stay, and patch-related adverse events. The results of this study may provide evidence for the use of anti-bloating patches as an adjunctive intervention to enhance postoperative gastrointestinal recovery in patients undergoing cardiac surgery.
Detailed description
Background Postoperative gastrointestinal dysfunction is frequently observed after cardiac surgery because of surgical stress, cardiopulmonary bypass, anesthesia, opioid administration, and prolonged bed rest. Gastric distension may contribute to patient discomfort, delayed gastrointestinal recovery, prolonged hospitalization, and increased healthcare utilization. Although anti-bloating patches are commonly used as a complementary intervention in perioperative care, evidence regarding their efficacy in cardiac surgery patients remains insufficient. Objective To evaluate the clinical efficacy and safety of anti-bloating patch therapy for postoperative gastric distension in patients undergoing cardiac surgery and to establish an objective imaging-based method for quantitative assessment of gastric bubble area. Methods This is a prospective, randomized, controlled, single-center clinical trial. A total of 150 adult patients undergoing elective cardiac surgery will be enrolled and randomly assigned in a 1:1 ratio to either an anti-bloating patch group or a control group. Participants in the control group will receive standard perioperative management. Participants in the intervention group will receive anti-bloating patch therapy in addition to standard perioperative management. Chest radiographs obtained on the day of surgery and on postoperative day 1 will be analyzed using ImageJ software. Gastric bubble area will be independently measured by trained investigators according to a predefined protocol
Interventions
OTHERAnti-Bloating Patch
Participants will receive anti-bloating patch treatment according to the study protocol in addition to standard perioperative care after cardiac surgery.
Standard perioperative management following cardiac surgery, including routine monitoring, fluid management, nutritional support, pain control, gastrointestinal function assessment, and other standard treatments as clinically indicated.
Sponsors
Southeast University, China
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
This is an open-label study. Participants and investigators are aware of group assignments. Outcome assessment of gastric bubble area will be performed using standardized imaging analysis procedures.
Intervention model description
Participants will be randomly assigned in a 1:1 ratio to either the anti-bloating patch group or the control group. The intervention group will receive anti-bloating patch treatment in addition to standard perioperative care, while the control group will receive standard perioperative care alone. Outcomes will be compared between the two groups.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * Undergoing elective cardiac surgery * Postoperative chest radiographs available for gastric bubble area assessment * Able to provide written informed consent or have consent provided by a legally authorized representative * Expected postoperative intensive care unit admission
Exclusion criteria
* Previous major gastrointestinal surgery affecting gastric anatomy or motility * Known gastrointestinal obstruction, perforation, or severe gastrointestinal disease * Severe hepatic or renal dysfunction judged unsuitable by the investigators * Known allergy or hypersensitivity to components of the anti-bloating patch * Participation in another interventional clinical trial within the previous 30 days * Pregnancy or lactation * Inability to complete study assessments or follow study procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Gastric Bubble Area on Postoperative Day 1 | Postoperative Day 1 | Change in gastric bubble area measured on chest radiographs from the day of surgery to postoperative day 1. Gastric bubble area will be quantified using ImageJ software and calculated as: postoperative day 1 gastric bubble area minus baseline gastric bubble area measured on the day of surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gastric Bubble Area on Postoperative Day 1 | Postoperative Day 1 | Absolute gastric bubble area measured on chest radiographs using ImageJ software. |
| Percentage Change in Gastric Bubble Area | Postoperative Day 1 | Percentage change in gastric bubble area from the day of surgery to postoperative day 1. |
| Abdominal Distension Score | Postoperative Day 1 | Patient-reported abdominal distension severity assessed using a Numerical Rating Scale (NRS) ranging from 0 to 10, where 0 indicates no abdominal distension and 10 indicates the worst imaginable abdominal distension. Higher scores indicate more severe abdominal distension. |
| Time to First Flatus | From surgery until first flatus, up to hospital discharge | Time from completion of surgery to first passage of flatus. |
| Time to First Bowel Movement | From surgery until first bowel movement, up to hospital discharge | Time from completion of surgery to first bowel movement. |
| Gastric Drainage Volume | Within 24 hours after surgery | Total gastric drainage volume recorded during the first 24 postoperative hours. |
| Time to Oral Feeding | Through hospital discharge, an average of 10 days | Time from completion of surgery to first oral intake, measured in hours. |
| Intensive Care Unit Length of Stay | Through ICU discharge, an average of 3 days | Duration of stay in the intensive care unit, measured in hours or days. |
| Postoperative Hospital Length of Stay | Through hospital discharge, an average of 10 days | Duration of hospitalization after surgery, measured in days. |
| Incidence of Patch-Related Adverse Events | From patch application through hospital discharge, an average of 10 days | Incidence of adverse events related to anti-bloating patch application, including skin irritation, rash, itching, allergic reactions, or other treatment-related adverse events. |
Countries
China
Contacts
CONTACTXu Jingyuan, Director
Outcome results
None listed