Investigation and analysis of influence factors of thirst in ICU patients with oral tracheal intubation and ventilator assisted ventilation_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WU Chunlan , LUO Qian , FU Bao , ZHANG Xia , FU Xiaoyun ,  CHEN Fang

Intensive Care Unit, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P. R. China;

Corresponding?author：

CHEN Fang, Email: 307811319@qq.com

Keywords：

Oral tracheal intubation; thirst; mechanical ventilation; influence factors

DOI：

10.7507/1671-6205.202203058

Video：

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Objective To investigate the thirst status of patients in intensive care unit (ICU) who underwent oral tracheal intubation and ventilator assisted ventilation, and explore its influence factors. Methods A total of 172 patients with oral tracheal intubation admitted in ICU from June 2020 to September 2021 were investigated, and a numerical rating scale was employed for rating their thirst feelings. The patients were divided into a thirst group and a non-thirst group based on thirst status. The thirst status and influence factors of thirst distress were analyzed. Results The incidence of thirst in the ICU patients with oral tracheal intubation and ventilator assisted ventilation was 88.4%, and the thirst score in the thirst group was 7.70±1.17. Single factor analysis showed statistically significant difference between the two groups in sex, medical payment, smoking, drinking, duration of mechanical ventilation, humidification effect, sputum viscosity, gastrointestinal decompression, fasting, continuous renal replacement therapy, diuretics, 24-hour urine volume and liquid balance, heart function grading, sedatives, agitation, sweating, acute physiology and chronic health evaluation Ⅱ, endotracheal intubation depth, body mass index, PCO₂, PO_2, HCO₃^–, tidal volume, and sodium ion (all P<0.05). Multivariable regression analysis demonstrated that diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, intubation depth, and cardiac function were independent influence factors for the occurrence of thirst in the ICU patients who received tracheal intubation (P<0.01). Conclusions The incidence of thirst was high in ICU patients with airway intubation and ventilator assisted ventilation. Diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, 24-hour urine volume, and cardiac function grading were independent influence factors for the occurrence of thirst in ICU patients with tracheal intubation. It is necessary to implement targeted intervention to prevent and alleviate the thirst degree of patients, reduce the occurrence of related complications, and improve patient comfort.

Citation： WU Chunlan, LUO Qian, FU Bao, ZHANG Xia, FU Xiaoyun, CHEN Fang. Investigation and analysis of influence factors of thirst in ICU patients with oral tracheal intubation and ventilator assisted ventilation. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(5): 316-321. doi: 10.7507/1671-6205.202203058 Copy

1.	Oka Y, Ye M, Zuker CS. Thirst driving and suppressing signals encoded by distinct neural populations in the brain. Nature, 2015, 520(7547): 349-352.
2.	Allida SM, Inglis SC, Davidson PM, et al. A survey of views and opinions of health professionals managing thirst in chronic heart failure. Contemp Nurse, 2016, 52(2-3): 244-252.
3.	Waldréus N, Chung ML, van der Wal MHL, et al. Trajectory of thirst intensity and distress from admission to 4-weeks follow up at home in patients with heart failure. Patient Prefer Adherence, 2018, 12: 2223-2231.
4.	Ho V, Goh G, Tang XR, et al. Underrecognition and undertreatment of thirst among hospitalized patients with restricted oral feeding and drinking. Sci Rep, 2021, 11(1): 13636.
5.	Sato K, Okajima M, Taniguchi T. Association of persistent intense thirst with delirium among critically ill patients: a cross-sectional study. J Pain Symptom Manage, 2019, 57(6): 1114-1120.
6.	莊耀寧, 謝穎彬, 黃美春, 等. ICU無創機械通氣患者口渴感水平及影響因素分. 護理學雜志, 2019, 34(7): 19-21.
7.	刁齊翔, 陳玉紅. 手術后患者口渴的護理研究進展. 護理學雜志, 2017, 32(22): 106-110.
8.	Negro A, Villa G, Greco M, et al. Thirst in patients admitted to intensive care units: an observational study. Ir J Med Sci, 2021: 1-7.
9.	方玲艷. 重癥監護病房患者口渴感及其相關因素調查. 中國醫院統計, 2018, 25(3): 179-182.
10.	Puntillo K, Nelson JE, Weissman D, et al. Palliative care in the ICU: relief of pain, dyspnea, and thirst-a report from the IPAL-ICU Advisory Board. Intensive Care Med, 2014, 40(2): 235-248.
11.	Gültekin Y, ?z?elik Z, Ak?nc? SB, et al. Evaluation of stressors in intensive care units. Turk J Surg, 2018, 34(1): 5-8.
12.	蔣玲潔. ICU機械通氣患者口渴的影響因素研究. 蘭州大學, 2020.
13.	張雪. ICU危重患者發生口渴的影響因素分析. 當代護士, 2021, 28(2): 21-23.
14.	Lee CW, Liu ST, Cheng YJ, et al. Prevalence, risk factors, and optimized management of moderate-to-severe thirst in the post-anesthesia care unit. Sci Rep, 2020, 10(1): 16183.
15.	Leal SC, Bittar J, Portugal A, et al. Medication in elderly people: its influence on salivary pattern, signs and symptoms of dry mouth. Gerodontology, 2010, 27(2): 129-133.
16.	Stotts NA, Arai SR, Cooper BA, et al. Predictors of thirst in intensive care unit patients. J Pain Symptom Manage, 2015, 49(3): 530-538.
17.	Bichet DG. Vasopressin and the regulation of thirst. Ann Nutr Metab, 2018, 72 Suppl 2: 3-7.
18.	吳超, 溫尊甲, 沈梅芬, 等. 高滲鹽水霧化對氣管切開早期病人痰液的影響. 護理研究, 2018, 32(21): 3473-3476.
19.	D'Sylva P, Caudri D, Shaw N, et al. Induced sputum to detect lung pathogens in young children with cystic fibrosis. Pediatr Pulmonol, 2017, 52(2): 182-189.
20.	孫嘉陽, 郭占林. 改良體位痰液引流治療心胸外科術后肺部感染的效果. 中華醫院感染學雜志, 2020, 30(5): 717-720.
21.	王潘, 唐春苑, 葉曉青, 等. 維持性血液透析患者口渴感及其影響因素的研究進展. 中國血液凈化, 2017, 16(5): 326-328.
22.	Stricker EM, Woods SC, Smith GP, et al. Neurobiology of food and fluid intake. Handbook of Behavioral Neurobiology, 2004, 507-545.
23.	陳慧. 吸煙對肺功能的影響及清肺戒煙茶干預戒煙的作用. 河北北方學院, 2019.
24.	Proctor GB, Shori DK, Preedy VR. Protein synthesis in the major salivary glands of the rat and the effects of refeeding and acute ethanol injection. Arch Oral Biol, 1993, 38(11): 971-978.
25.	Ujihara I, Hitomi S, Ono K, et al. The ethanol metabolite acetaldehyde induces water and salt intake via two distinct pathways in the central nervous system of rats. Neuropharmacology, 2015, 99: 589-599.
26.	Chung CJ, Jeong SY, Jeong JH, et al. Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study. Anesth Pain Med (Seoul), 2021, 16(2): 163-170.
27.	Higgs A, Mcgrath BA, Goddard C, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018, 120(2): 323-352.
28.	孫冠群, 朱莎, 劉國杰. 心力衰竭患者口渴困擾現狀及影響因素研究. 護理學雜志, 2020, 35(16): 25-28.
29.	van der Wal MHL, Waldréus N, Jaarsma T, et al. Thirst in patients with heart failure in Sweden, the Netherlands, and Japan. J Cardiovasc Nurs, 2020, 35(1): 19-25.
30.	Eng SH, Waldréus N, González B, et al. Thirst distress in outpatients with heart failure in a Mediterranean zone of Spain. ESC Heart Fail, 2021, 8(4): 2492-2501.

1. Oka Y, Ye M, Zuker CS. Thirst driving and suppressing signals encoded by distinct neural populations in the brain. Nature, 2015, 520(7547): 349-352.
2. Allida SM, Inglis SC, Davidson PM, et al. A survey of views and opinions of health professionals managing thirst in chronic heart failure. Contemp Nurse, 2016, 52(2-3): 244-252.
3. Waldréus N, Chung ML, van der Wal MHL, et al. Trajectory of thirst intensity and distress from admission to 4-weeks follow up at home in patients with heart failure. Patient Prefer Adherence, 2018, 12: 2223-2231.
4. Ho V, Goh G, Tang XR, et al. Underrecognition and undertreatment of thirst among hospitalized patients with restricted oral feeding and drinking. Sci Rep, 2021, 11(1): 13636.
5. Sato K, Okajima M, Taniguchi T. Association of persistent intense thirst with delirium among critically ill patients: a cross-sectional study. J Pain Symptom Manage, 2019, 57(6): 1114-1120.
6. 莊耀寧, 謝穎彬, 黃美春, 等. ICU無創機械通氣患者口渴感水平及影響因素分. 護理學雜志, 2019, 34(7): 19-21.
7. 刁齊翔, 陳玉紅. 手術后患者口渴的護理研究進展. 護理學雜志, 2017, 32(22): 106-110.
8. Negro A, Villa G, Greco M, et al. Thirst in patients admitted to intensive care units: an observational study. Ir J Med Sci, 2021: 1-7.
9. 方玲艷. 重癥監護病房患者口渴感及其相關因素調查. 中國醫院統計, 2018, 25(3): 179-182.
10. Puntillo K, Nelson JE, Weissman D, et al. Palliative care in the ICU: relief of pain, dyspnea, and thirst-a report from the IPAL-ICU Advisory Board. Intensive Care Med, 2014, 40(2): 235-248.
11. Gültekin Y, ?z?elik Z, Ak?nc? SB, et al. Evaluation of stressors in intensive care units. Turk J Surg, 2018, 34(1): 5-8.
12. 蔣玲潔. ICU機械通氣患者口渴的影響因素研究. 蘭州大學, 2020.
13. 張雪. ICU危重患者發生口渴的影響因素分析. 當代護士, 2021, 28(2): 21-23.
14. Lee CW, Liu ST, Cheng YJ, et al. Prevalence, risk factors, and optimized management of moderate-to-severe thirst in the post-anesthesia care unit. Sci Rep, 2020, 10(1): 16183.
15. Leal SC, Bittar J, Portugal A, et al. Medication in elderly people: its influence on salivary pattern, signs and symptoms of dry mouth. Gerodontology, 2010, 27(2): 129-133.
16. Stotts NA, Arai SR, Cooper BA, et al. Predictors of thirst in intensive care unit patients. J Pain Symptom Manage, 2015, 49(3): 530-538.
17. Bichet DG. Vasopressin and the regulation of thirst. Ann Nutr Metab, 2018, 72 Suppl 2: 3-7.
18. 吳超, 溫尊甲, 沈梅芬, 等. 高滲鹽水霧化對氣管切開早期病人痰液的影響. 護理研究, 2018, 32(21): 3473-3476.
19. D'Sylva P, Caudri D, Shaw N, et al. Induced sputum to detect lung pathogens in young children with cystic fibrosis. Pediatr Pulmonol, 2017, 52(2): 182-189.
20. 孫嘉陽, 郭占林. 改良體位痰液引流治療心胸外科術后肺部感染的效果. 中華醫院感染學雜志, 2020, 30(5): 717-720.
21. 王潘, 唐春苑, 葉曉青, 等. 維持性血液透析患者口渴感及其影響因素的研究進展. 中國血液凈化, 2017, 16(5): 326-328.
22. Stricker EM, Woods SC, Smith GP, et al. Neurobiology of food and fluid intake. Handbook of Behavioral Neurobiology, 2004, 507-545.
23. 陳慧. 吸煙對肺功能的影響及清肺戒煙茶干預戒煙的作用. 河北北方學院, 2019.
24. Proctor GB, Shori DK, Preedy VR. Protein synthesis in the major salivary glands of the rat and the effects of refeeding and acute ethanol injection. Arch Oral Biol, 1993, 38(11): 971-978.
25. Ujihara I, Hitomi S, Ono K, et al. The ethanol metabolite acetaldehyde induces water and salt intake via two distinct pathways in the central nervous system of rats. Neuropharmacology, 2015, 99: 589-599.
26. Chung CJ, Jeong SY, Jeong JH, et al. Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study. Anesth Pain Med (Seoul), 2021, 16(2): 163-170.
27. Higgs A, Mcgrath BA, Goddard C, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018, 120(2): 323-352.
28. 孫冠群, 朱莎, 劉國杰. 心力衰竭患者口渴困擾現狀及影響因素研究. 護理學雜志, 2020, 35(16): 25-28.
29. van der Wal MHL, Waldréus N, Jaarsma T, et al. Thirst in patients with heart failure in Sweden, the Netherlands, and Japan. J Cardiovasc Nurs, 2020, 35(1): 19-25.
30. Eng SH, Waldréus N, González B, et al. Thirst distress in outpatients with heart failure in a Mediterranean zone of Spain. ESC Heart Fail, 2021, 8(4): 2492-2501.

Chinese Journal of Respiratory and Critical Care Medicine

Investigation and analysis of influence factors of thirst in ICU patients with oral tracheal intubation and ventilator assisted ventilation

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