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.
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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
150
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.
Zhongda Hospital, Southeast University
Nanjing, Jiangsu, China
Change in Gastric Bubble Area on 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.
Time frame: Postoperative Day 1
Gastric Bubble Area on Postoperative Day 1
Absolute gastric bubble area measured on chest radiographs using ImageJ software.
Time frame: Postoperative Day 1
Percentage Change in Gastric Bubble Area
Percentage change in gastric bubble area from the day of surgery to postoperative day 1.
Time frame: Postoperative Day 1
Abdominal Distension Score
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 frame: Postoperative Day 1
Time to First Flatus
Time from completion of surgery to first passage of flatus.
Time frame: From surgery until first flatus, up to hospital discharge
Time to First Bowel Movement
Time from completion of surgery to first bowel movement.
Time frame: From surgery until first bowel movement, up to hospital discharge
Gastric Drainage Volume
Total gastric drainage volume recorded during the first 24 postoperative hours.
Time frame: Within 24 hours after surgery
Time to Oral Feeding
Time from completion of surgery to first oral intake, measured in hours.
Time frame: Through hospital discharge, an average of 10 days
Intensive Care Unit Length of Stay
Duration of stay in the intensive care unit, measured in hours or days.
Time frame: Through ICU discharge, an average of 3 days
Postoperative Hospital Length of Stay
Duration of hospitalization after surgery, measured in days.
Time frame: Through hospital discharge, an average of 10 days
Incidence of Patch-Related Adverse Events
Incidence of adverse events related to anti-bloating patch application, including skin irritation, rash, itching, allergic reactions, or other treatment-related adverse events.
Time frame: From patch application through hospital discharge, an average of 10 days
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