KORONER ARTER BYPASS GREFTLEME SONRASI GASTROİNTESTİNAL TOLERANS VE ELEKTROLİT DENGESİNE ERKEN ORAL MADEN SUYU HİDRATASYONUNUN ETKİSİ

Year 2025, Volume: 6 Issue: 3, 230 - 234, 25.11.2025

Üzeyir Yılmaz

Abstract

Giriş: Postoperatif oral hidrasyon sıvı–elektrolit dengesini ve gastrointestinal iyileşmeyi destekler; ancak kardiyak cerrahi hastaları için standartlaştırılmış beslenme kılavuzları bulunmamaktadır.

Yöntemler: Bu çalışmada, koroner arter bypass greftleme (CABG) sonrası erken dönemde oral maden suyu verilmesinin gastrointestinal tolerans, elektrolit dengesi ve klinik sonuçlar üzerine etkileri değerlendirildi. Ocak 2023 – Haziran 2024 tarihleri arasında izole CABG uygulanan 142 hasta retrospektif olarak incelendi. Hastalar iki gruba ayrıldı: Grup 1 (n = 71) ekstübasyondan sonraki iki saat içinde 200 mL soğutulmuş maden suyu aldı; Grup 2 (n = 71) ise standart hidrasyon uygulandı. Birincil sonlanım noktaları antiemetik gereksinimi, oral sıvı toleransı ve ilk gaz çıkarma süresiydi. İkincil sonlanım noktaları serum elektrolit değişiklikleri, atriyal fibrilasyon insidansı ve yoğun bakımda kalış süresiydi.

Bulgular: Gruplar demografik olarak benzerdi. Antiemetik gereksinimi maden suyu grubunda daha düşüktü (% 21,1’e karşı %71,8; p <0,001). Oral sıvı toleransı (medyan 5’e karşı 6,5 saat; p <0,001) ve ilk gaz çıkarma (medyan 19’a karşı 28 saat; p <0,001) daha erken gerçekleşti. Yoğun bakımda kalış süresi anlamlı olarak daha kısaydı (p = 0,009). Postoperatif magnezyum (2,2 ± 0,3’e karşı 1,9 ± 0,3 mmol/L; p <0,001) ve kalsiyum düzeyleri (p <0,001) maden suyu grubunda daha yüksekti ve gruplar içinde anlamlı postoperatif artış gözlendi.

Sonuç: CABG sonrası erken dönemde soğutulmuş maden suyu tüketimi daha iyi gastrointestinal tolerans, azalmış antiemetik ihtiyacı, iyileşmiş elektrolit profili ve daha kısa yoğun bakımda kalış süresi ile ilişkili bulundu. Maden suyu desteği, postoperatif kardiyak bakımda güvenli ve etkili bir tamamlayıcı yöntem olarak görünmektedir. Bu bulguların doğrulanması için prospektif randomize çalışmalara ihtiyaç vardır.

Keywords

Koroner arter bypass cerrahisi , Postoperatif bakım , Maden suyu

Ethical Statement

Bu çalışma, tek merkezli retrospektif kohort analizi olarak tasarlanmıştır. Ocak 2023 ile Haziran 2024 tarihleri ​​arasında izole koroner arter baypas greftleme (KABG) uygulanan toplam 142 hasta retrospektif olarak değerlendirilmiştir. Çalışma protokolü Kastamonu Üniversitesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmış (Onay No: 2024-KAEK-174) ve Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.

Supporting Institution

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Thanks

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EFFECT OF EARLY ORAL MINERAL WATER HYDRATION ON GASTROINTESTINAL TOLERANCE AND ELECTROLYTE BALANCE AFTER CORONARY ARTERY BYPASS GRAFTING

Abstract

Introduction: Postoperative oral hydration supports fluid–electrolyte balance and gastrointestinal recovery, but no standardized nutritional guidelines exist for cardiac surgery patients.

Methods: This study evaluated the effect of early oral mineral water administration on gastrointestinal tolerance, electrolyte balance, and clinical outcomes after coronary artery bypass grafting (CABG). A retrospective cohort of 142 patients undergoing isolated CABG between January 2023 and June 2024 was analyzed. Patients were divided into two groups: Group 1 (n = 71) received 200 mL of chilled mineral water within two hours after extubation; Group 2 (n = 71) received standard hydration. Primary outcomes included antiemetic requirement, oral fluid tolerance, and time to first flatus. Secondary outcomes were serum electrolyte changes, atrial fibrillation incidence, and ICU length of stay.

Results: Groups were comparable in demographics. Antiemetic requirement was lower in the mineral water group (21.1% vs. 71.8%, p <0.001). Oral fluid tolerance (median 5 vs. 6.5 hours, p <0.001) and first flatus (median 19 vs. 28 hours, p <0.001) occurred earlier. ICU stay was modestly but significantly shorter (p = 0.009). Postoperative magnesium (2.2 ± 0.3 vs. 1.9 ± 0.3 mmol/L, p <0.001) and potassium levels (p <0.001) were higher in the mineral water group, with significant within-group postoperative increases

Conclusion: Early chilled mineral water intake after CABG was associated with better gastrointestinal tolerance, reduced antiemetic need, improved electrolyte profiles, and shorter ICU stay. Mineral water supplementation appears to be a safe and effective adjunct in postoperative cardiac care. Prospective randomized trials are needed to confirm these findings

Keywords

Coronary artery bypass grafting , Postoperative care , Mineral water

Ethical Statement

This study was designed as a single-center retrospective cohort analysis. Between January 2023 and June 2024, a total of 142 patients who underwent isolated coronary artery bypass grafting (CABG) were retrospectively evaluated. The study protocol was approved by the Kastamonu University Clinical Research Ethics Committee (Approval No: 2024-KAEK-174) and conducted in accordance with the principles of the Declaration of Helsinki.

Supporting Institution

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