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Effectiveness of non-pharmacological interventions for thirst in ICU patients: a systematic review and network

Meng Xiao¹, Fangfang Zhu², Yanting Zhang¹

¹Department of Critical Care Medicine, Hubei Clinical Research Center for Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.

|April 1, 2025

Abstract

Aim:

This study systematically compared the efficacy of non-pharmacological interventions that may improve thirst in intensive care unit (ICU) patients.

Background:

Thirst is among the most intense and distressing symptoms experienced by ICU patients. Recently, various non-pharmacological interventions have been applied to alleviate thirst symptoms and have shown positive effects. However, there is no consensus on which non-pharmacological intervention is the most effective, making it difficult to choose interventions to alleviate thirst in ICU patients.

Design:

Systematic review and network meta-analysis based on PRISMA.

Methods:

Computer searches were conducted in eight Chinese and English databases to identify randomized controlled trials published before October 12, 2024, on non-pharmacological interventions to improve thirst symptoms in ICU patients. Two researchers performed literature screening and data extraction, and RevMan 5.3 and Stata 15.0 software were used for literature quality assessment and data analysis.

Results:

24 articles involving 2480 ICU patients and 14 types of non-drug interventions were included. The network meta-analysis results revealed that compared with those in routine care, the degree of thirst in ICU patients was significantly different significant for menthol lozenges, ice water injection, menthol water spray, ice saline water spray, ice menthol water spray, and ice water spray (all P < 0.05). According to the ranking results of the cumulative ranking probability curve area (SUCRA), ice menthol water spray is the optimal solution for improving the degree of thirst in ICU patients.

Conclusion:

Ice menthol water spray is the best non-pharmacological intervention for reducing thirst in ICU patients. When patients experience thirst, such as in the ICU ward, medical staff can use ice peppermint water spray to relieve the patient's thirst symptoms. Future research should focus on directly comparing the effects of different non-pharmacological interventions and evaluating their cost-effectiveness. PROSPERO (INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS)REGISTRATION NUMBER: CRD42024614636.

Relevance To Clinical Practice:

The results of this study can provide a basis for medical staff to alleviate the thirst of ICU patients, with the results particularly supporting the use of ice mint water spray to reduce the level of thirst in ICU patients.

Keywords:

Critically ill patients Network meta-analysis Non-pharmacological interventions Thirst

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