Nancy A Stotts1, Shoshana R Arai2, Bruce A Cooper2, Judith E Nelson3, Kathleen A Puntillo2. 1. University of California San Francisco, San Francisco, California, USA. Electronic address: nancy.stotts@nursing.ucsf.edu. 2. University of California San Francisco, San Francisco, California, USA. 3. Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
CONTEXT: Thirst is a pervasive, intense, and distressing symptom in intensive care unit (ICU) patients. Although thirst may be avoided and/or treated, scant data are available to help providers identify patients most in need. OBJECTIVES: This study was designed to identify predictors of the presence, intensity, and distress of thirst in ICU patients. METHODS: This descriptive cross-sectional study enrolled 353 patients from three ICUs (medical-surgical, cardiac, and neurological). To measure outcomes, patients were asked to report the presence of thirst (yes/no) and, if present, to rate its intensity and distress on zero to 10 numeric rating scales (10=worst). Predictor variables were demographic (e.g., age), treatment-related (e.g., opioids), and biological (e.g., total body water). Data were analyzed with logistic regression and truncated regression with alpha preset at 0.05. RESULTS: Thirst presence was predicted by high opioid doses (≥ 50 mg), high furosemide doses (>60 mg), selective serotonin reuptake inhibitors, and low ionized calcium. Thirst intensity was predicted by patients not receiving oral fluid and having a gastrointestinal (GI) diagnosis. Thirst distress was predicted by mechanical ventilation, negative fluid balance, antihypertensive medications, and a GI or "other" diagnosis. CONCLUSION: Thirst presence was predicted by selected medications (e.g., opioids). Thirst intensity and/or thirst distress were predicted by other treatments (e.g., mechanical ventilation) and medical diagnoses (e.g., GI). This is one of the first studies describing predictors of the multidimensional characteristics of thirst. Clinicians can use these data to target ICU patients whose thirst might warrant treatment.
CONTEXT: Thirst is a pervasive, intense, and distressing symptom in intensive care unit (ICU) patients. Although thirst may be avoided and/or treated, scant data are available to help providers identify patients most in need. OBJECTIVES: This study was designed to identify predictors of the presence, intensity, and distress of thirst in ICU patients. METHODS: This descriptive cross-sectional study enrolled 353 patients from three ICUs (medical-surgical, cardiac, and neurological). To measure outcomes, patients were asked to report the presence of thirst (yes/no) and, if present, to rate its intensity and distress on zero to 10 numeric rating scales (10=worst). Predictor variables were demographic (e.g., age), treatment-related (e.g., opioids), and biological (e.g., total body water). Data were analyzed with logistic regression and truncated regression with alpha preset at 0.05. RESULTS: Thirst presence was predicted by high opioid doses (≥ 50 mg), high furosemide doses (>60 mg), selective serotonin reuptake inhibitors, and low ionizedcalcium. Thirst intensity was predicted by patients not receiving oral fluid and having a gastrointestinal (GI) diagnosis. Thirst distress was predicted by mechanical ventilation, negative fluid balance, antihypertensive medications, and a GI or "other" diagnosis. CONCLUSION: Thirst presence was predicted by selected medications (e.g., opioids). Thirst intensity and/or thirst distress were predicted by other treatments (e.g., mechanical ventilation) and medical diagnoses (e.g., GI). This is one of the first studies describing predictors of the multidimensional characteristics of thirst. Clinicians can use these data to target ICU patients whose thirst might warrant treatment.
Authors: Glenn M Chertow; Z John Lu; Xiao Xu; Tyler G Knight; William G Goodman; David A Bushinsky; Geoffrey A Block Journal: Hemodial Int Date: 2012-04 Impact factor: 1.812
Authors: Kathleen A Puntillo; Shoshana Arai; Neal H Cohen; Michael A Gropper; John Neuhaus; Steven M Paul; Christine Miaskowski Journal: Crit Care Med Date: 2010-11 Impact factor: 7.598
Authors: Ana Paula de Magalhães-Nunes; Daniel Badauê-Passos; Renato Rizo Ventura; Daniel da Silva Guedes; Jacqueline Pereira Araújo; Priscila Camargo Granadeiro; Hevellyn Katarine Milanez-Barbosa; Ricardo Henrique da Costa-e-Sousa; Magda Alves de Medeiros; José Antunes-Rodrigues; Luís Carlos Reis Journal: Exp Physiol Date: 2007-06-15 Impact factor: 2.969