Predictors of Thirst in Intensive Care Unit Patients
Abstract
Context. 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.
Objectives. 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 ¼ 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.
Conclusion. 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. J Pain Symptom Manage 2014;-:-e-. 2014 American Academy of Hospice and
Palliative Medicine. Published by Elsevier Inc. All rights reserved.