Abstract

Thirst is defined as an uncomfortable sensation associated with the desire or need to drink something (Çiftçi, et al., 2023). From a physiological perspective, it can occur from one of two pathways. Either there can be an intracellular fluid deficit with increased serum osmolality (osmotic thirst) or an extracellular fluid deficit (hypovolemic thirst) (Flim, et al., 2022). Signals of thirst may include dryness in the mouth or throat, or thirst sensation can be triggered by routine or longing for a drug in a beverage (e.g., caffeine, alcohol) or desire for a liquid that is either cool or warm (Puntillo et al., 2010).

Critically ill patients in the intensive care unit (ICU) report thirst as one of the most distressing symptoms they experience along with pain, dyspnea, anxiety, sleep deprivation, and being in restraints (Chanques et al., 2015). Data suggests that more than 70% of patients in the ICU experience thirst and up to 52%, of patients rate thirst gravity as severe (Li & Puntillo, 2006). Several factors have been implicated in the development of thirst sensations in patients in the ICU. These include medications (e.g., diuretics, anxiolytics, antihistamines, opioids, some antidepressants, anticholinergics, nonsteroidal anti-inflammatory drugs), mechanical ventilation, and having no oral fluids administered (Flim et al., 2022). Medical conditions (e.g., dehydration [from fever, blood loss, vomiting or diarrhea], diabetes, HIV/AIDS, Sjogren’s syndrome, stroke, hypertension) and treatment modalities (e.g., chemotherapy, NPO status) have been implicated in the development of dry mouth, which can trigger a thirst sensation (Negro et al., 2022).

Despite thirst being identified as a distressing symptom for patients, it is typically not assessed or treated by nurses in the ICU. Strategies to mitigate thirst are essential for quality patient outcomes.

Notes

References:

Çiftçi et al. (2023). Development of the thirst discomfort scale: A validity and reliability study. American Journal of Critical Care, 32(3), 176-183.

Chanques et al. (2015). Five patient symptoms that you should evaluate every day. Intensive Care Medicine. 41, 1347–1350.

Flim et al. (2022). Thirst in adult patients in the intensive care unit: protocol for a scoping review. BMJ Open, 12(11). e063006.

Negro et al. (2022). Thirst in patients admitted to intensive care units: an observational study. British Journal of Biomedical Science: https://DOI: 10.1007/s11845-021-02817-7

Puntillo et al. (2010). Symptoms experienced by intensive care unit patients at high risk of dying. Critical Care Medicine, 38, 2155–2160.

Description

The purpose of this study is to compare two protocols to decrease thirst in patients in the Medical ICU. This study used a cross-sectional descriptive pre-intervention/post-intervention randomized controlled design. It is important for nursing staff to assess for thirst in critically ill patients without depending on patient’s complaints of thirst. The present study suggests the spritz bottle intervention significantly reduced thirst intensity and distress compared to usual care.

Author Details

Kathleen Diatta, Ph.D. RN, NE-BC, NPD-BC, CCRN, FNAP;

Roberta Kaplow, Ph.D., APRN-CCNS, AOCNS, NPD-BC, CCRN, FNAP, FCCM, FAAN

Sigma Membership

Alpha Epsilon

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Implementation Science, Acute Care, Thirst, Intensive Care Patients, Intensive Care Units

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-11

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A Comparison of Thirst Management Strategies in Patients in the Intensive Care Unit

Toronto, Ontario, Canada

Thirst is defined as an uncomfortable sensation associated with the desire or need to drink something (Çiftçi, et al., 2023). From a physiological perspective, it can occur from one of two pathways. Either there can be an intracellular fluid deficit with increased serum osmolality (osmotic thirst) or an extracellular fluid deficit (hypovolemic thirst) (Flim, et al., 2022). Signals of thirst may include dryness in the mouth or throat, or thirst sensation can be triggered by routine or longing for a drug in a beverage (e.g., caffeine, alcohol) or desire for a liquid that is either cool or warm (Puntillo et al., 2010).

Critically ill patients in the intensive care unit (ICU) report thirst as one of the most distressing symptoms they experience along with pain, dyspnea, anxiety, sleep deprivation, and being in restraints (Chanques et al., 2015). Data suggests that more than 70% of patients in the ICU experience thirst and up to 52%, of patients rate thirst gravity as severe (Li & Puntillo, 2006). Several factors have been implicated in the development of thirst sensations in patients in the ICU. These include medications (e.g., diuretics, anxiolytics, antihistamines, opioids, some antidepressants, anticholinergics, nonsteroidal anti-inflammatory drugs), mechanical ventilation, and having no oral fluids administered (Flim et al., 2022). Medical conditions (e.g., dehydration [from fever, blood loss, vomiting or diarrhea], diabetes, HIV/AIDS, Sjogren’s syndrome, stroke, hypertension) and treatment modalities (e.g., chemotherapy, NPO status) have been implicated in the development of dry mouth, which can trigger a thirst sensation (Negro et al., 2022).

Despite thirst being identified as a distressing symptom for patients, it is typically not assessed or treated by nurses in the ICU. Strategies to mitigate thirst are essential for quality patient outcomes.