title: Predictors of thirst in intensive care unit patients.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.affiliation: University of California San Francisco, San Francisco, California, USA. Electronic address: nancy.stotts@nursing.ucsf.edu.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Stotts
authors.affiliation: University of California San Francisco, San Francisco, California, USA.
authors.forename: Shoshana R
authors.initials: SR
authors.lastname: Arai
authors.affiliation: University of California San Francisco, San Francisco, California, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cooper
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Nelson
authors.affiliation: University of California San Francisco, San Francisco, California, USA.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Puntillo
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects; D001007:Anxiety; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000009:adverse effects; D013894:Thirst
chemical_list: D000701:Analgesics, Opioid
keywords: ICU; Thirst; palliation; symptom