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Thirst is the most common self-reported symptom in intensive care unit (ICU) patients. There is evidence that oral cooling interventions may alleviate thirst symptoms in ICU patients. However, the evidence needs to be critically evaluated.
To investigate the effect of oral cooling interventions on alleviating thirst symptoms of ICU patients and explore the effectiveness of different types of oral cooling by subgroup analysis.
The PubMed, Ovid Embase, the Cochrane Library, Wanfang Data and China National Knowledge Infrastructure databases were searched from inception to 29 October 2023. Randomised controlled trials (RCTs) that reported thirst intensity or thirst distress as outcomes were included. The certainty of the evidence was evaluated by the GRADE approach.
The meta-analysis comprised eight RCTs that included 813 ICU patients. The pooled analysis from eight RCTs showed that oral cooling interventions had significant beneficial effects on thirst intensity (weighted mean difference [WMD] = −2.73, 95% confidence interval [CI] = −3.62 to −1.85, p < 0.01; moderate certainty). The pooled analysis from four RCTs showed that oral cooling interventions could significantly lower the thirst distress scores (standardised mean difference = −0.80, 95% CI = −1.13 to −0.47, p < 0.01; low certainty). Subgroup analysis indicated that cold stimulation (WMD = −3.12) and cold combined with menthol stimulation (WMD = −1.72) could significantly lower the thirst intensity scores.
Oral cooling interventions including cold and menthol had beneficial effects on thirst intensity and thirst distress in ICU patients. The high heterogeneity in methods should be considered when interpreting the results.
This study provides references for the application of oral care strategy in the ICU care field, and encourages nurses to apply the oral cooling plan to improve patients' comfort.
This was a meta-analysis based on data from previous studies.
PROSPERO: CRD42023416059
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