Symptom management to alleviate thirst and dry mouth in critically ill patients: A randomised controlled trial

Background: Critically ill patients often experience coexisting symptoms. Thirst, in particular, appears to be an important symptom, having the highest prevalence, intensity, and induction of distress, and is significantly correlated with other symptoms. However, thirst and dry mouth are not usually assessed or treated. Objectives: The aim of the study was to demonstrate the effectiveness of an intervention bundle to relieve thirst and dry mouth. Methods: The present study was a randomised controlled trial in which critically ill patients were allocated to an experimental or control group. The intervention bundles, including vitamin C sprays, peppermint water mouthwash, and a lip moisturiser, were provided to the experimental group for 3 days, whereas patients in the control group were exposed to the placebo interventions, including saline sprays, 40 degrees C water mouthwash, and wetting the lips with water. Results: A total of 61 patients were recruited to the study; 65.6% (n = 41) were men, and the average age was 64.2 +/- 16.8 years. The average decrease in thirst intensity and oral mucosa situation scores after the interventions was larger in the experimental group patients relative to controls (1.27 and 0.36 vs. 0.19 and 0.1 points, respectively; p < 0.05). Being male, scoring highly on the Acute Physiology and Chronic Health Evaluation II scale, not receiving diuretics, and having higher serum sodium levels were potential predictors of thirst and oral dryness. Conclusions: The interventional bundle used in this study was shown to be a promising approach that can relieve thirst intensity and dry mouth, which are pervasively distressful to critically ill patients. (C) 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.