A randomized clinical trial of an intervention to relieve thirst and dry mouth in intensive care unit patients
- 2.4k Downloads
To test an intervention bundle for thirst intensity, thirst distress, and dry mouth, which are among the most pervasive, intense, distressful, unrecognized, and undertreated symptoms in ICU patients, but for which data-based interventions are lacking.
This was a single-blinded randomized clinical trial in three ICUs in a tertiary medical center in urban California. A total of 252 cognitively intact patients reporting thirst intensity (TI) and/or thirst distress (TD) scores ≥3 on 0–10 numeric rating scales (NRS) were randomized to intervention or usual care groups. A research team nurse (RTN#1) obtained patients’ pre-procedure TI and TD scores and reports of dry mouth. She then administered a thirst bundle to the intervention group: oral swab wipes, sterile ice-cold water sprays, and a lip moisturizer, or observed patients in the usual care group. RTN#2, blinded to group assignment, obtained post-procedure TI and TD scores. Up to six sessions per patient were conducted across 2 days.
Multilevel linear regression determined that the average decreases in TI and TD scores from pre-procedure to post-procedure were significantly greater in the intervention group (2.3 and 1.8 NRS points, respectively) versus the usual care group (0.6 and 0.4 points, respectively) (p < 0.05). The usual care group was 1.9 times more likely than the intervention group to report dry mouth for each additional session on day 1.
This simple, inexpensive thirst bundle significantly decreased ICU patients’ thirst and dry mouth and can be considered a practice intervention for patients experiencing thirst.
KeywordsThirst relief Dry mouth ICU Symptom Non-pharmacological Palliation
- 3.Sreenbny LM (1996) Xerostomia: diagnosis, management and clinical complications. In: Edgar WM, O’Mullane DM (eds) Saliva and oral health. British Dental Association, London, pp 43–66Google Scholar
- 6.Rose L, Nonoyama M, Rezaie S, Fraser I (2013) Psychological wellbeing, health related quality of life and memories of intensive care and a specialised weaning centre reported by survivors of prolonged mechanical ventilation. Intensive Crit Care Nurs. doi:10.1016/j.iccn.2013.11.002 PubMedGoogle Scholar
- 14.Pear S (2007) The role of oral care in the prevention of hospital-acquired pneumonia. Infection Control Today 11(10):1–3Google Scholar
- 19.Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R (2011) Interventions for the management of dry mouth: topical therapies. Cochrane Database Syst Rev 12:CD008934Google Scholar
- 22.Tomioko T, Inomata K, Nakaoka M, Futakami J, Yamada Y, Watanabe M, Takao S, Yokoyama Y (2006) Support for heart failure patients with thirst induced by fluid restriction: usefulness of a spray with sufficient sialogogic effect. J Kushiro City Gen Hosp 18:29–32Google Scholar
- 34.Hox J (2002) Multilevel analysis: techniques and applications. Lawrence Erlbaum Associates, MahwahGoogle Scholar