title: A randomized clinical trial of an intervention to relieve thirst and dry mouth in intensive care unit patients.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  This simple, inexpensive thirst bundle significantly decreased ICU patients' thirst and dry mouth and can be considered a practice intervention for patients experiencing thirst.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA, Kathleen.puntillo@nursing.ucsf.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Puntillo
authors.forename: Shoshana R
authors.initials: SR
authors.lastname: Arai
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cooper
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Stotts
authors.forename: Judith E
authors.initials: JE
authors.lastname: Nelson
mesh_terms: D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013894:Thirst; D014987:Xerostomia / Q000628:therapy*