Intense Thirst Research Articles

Prevalence and Predictors of Thirst in Patients With Heart Failure.

Thirst is among the most unpleasant symptoms in patients with heart failure (HF). Intense thirst can lead to uncontrolled fluid intake, resulting in congestion and frequent readmissions. Many predictors of thirst were identified, but little research addressed its association with salt intake. The aims were to describe the prevalence and characteristics of thirst in patients with HF, examine its association with salt intake, and identify its predictors. Using a descriptive correlational design, 100 patients with New York Heart Association classes I, II, and III HF were interviewed about thirst, salt-related behaviors, and the Patient Health Questionnaire-2. Demographic and clinical information were extracted from medical records. Descriptive statistics as well as bivariate and multivariable regression analyses were used. Most participants were male and married, with university education and a mean age of 66.7 ± 13.2 years. The mean thirst intensity score was 3.81 ± 2.17 (out of 10), and its prevalence was 93%. The mean thirst distress score was 23.58 ± 7.66 (out of 40); 68% reported moderate or strong distress. Patients prescribed salt restriction had lower thirst intensity (3.60 vs 5.70, P = .003) than their counterparts and thirst distress (22.78 vs 27.50, P = .062) that approached significance. Salt restriction; use of statins, antidepressants, and any renin angiotensin aldosterone system (RAAS) blocker; and Patient Health Questionnaire-2 score predicted thirst intensity. Female sex as well as use of any RAAS blocker and antidepressants predicted thirst distress. Thirst was prevalent, distressing, and predicted by salt restriction, use of any RAAS blocker, and depression. Assessing thirst and relieving it are recommended.

The assessment of reliability and validity of the Thai Versions of the Thirst Distress Scale for patients with Heart Failure and the Simplified Nutritional Appetite Questionnaire in heart failure patients.

Heart failure (HF) patients can experience poor appetite and intense thirst. The Thirst Distress Scale for HF (TDS-HF) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are tools used to assess these symptoms. However, these questionnaires are not currently available in Thai. To translate the TDS-HF and SNAQ into the Thai language and to evaluate the reliability and validity of these translated instruments. The TDS-HF and the SNAQ were translated from English to Thai using a forward-backward method. Their face and content validity, their internal consistency and test-retest reliability, were assessed with a sample of 20 HF patients recruited from a single supra-tertiary hospital in Thailand. Participants reported that the TDS-HF and the SNAQ had face validity. The content validity was assessed as adequate by the expert panel. The Cronbach's alphas of the TDS-HF and the SNAQ were 0.91 and 0.71, respectively. The intraclass correlation coefficients of the TDS-HF and the SNAQ were 0.91 and 0.91, respectively. The Thai versions of the TDS-HF and the SNAQ demonstrate adequate validity and reliability. These tools hold significant potential for supporting clinical practice, particularly for nurses involved in HF management by helping to assess thirst and appetite effectively.

Dynamic change and risk factors of intense thirst in patients admitted to neuro-intensive care unit: An observational study.

Thirst is a clinical discomfort symptom reported by most patients admitted to intensive care unit (ICU). Little is known about the dynamic change and risk factors of intense thirst in neuro-intensive care unit (Neuro-ICU). The objective of this study was to explore the dynamic change and determine the risk factors of intense thirst in patients admitted to Neuro-ICU, providing reference for personalized interventions of intense thirst. The study design is a prospective observational study. Demographic and disease-related,treatment, physiological and biochemical data were collected for 230 patients from Neuro-ICU of a hospital from May 2023 to November 2023. We assessed thirst intensity on numeric rating scale (NRS) of 0-10 (10 = worst possible thirst) at eight time points: 7:00, 9:00, 11:00, 13:00, 15:00, 17:00, 19:00 and 21:00 and a self-designed general information questionnaire based on safety protocol for thirst management to analyse the risk factors of intense thirst in Neuro-ICU patients. If thirst scores were more than 7, we defined it as intense thirst. This study followed the STROBE checklist for cross-sectional studies. A total of 230 Neuro-ICU patients were observed. The dynamic analysis results showed an overall downward trend in thirst intensity, with the highest NRS thirst scores at 07:00 (6.13 ± 2.14) and the lowest at 21:00 (4.02 ± 2.72). The investigation of the current situation showedthat the incidence of intense thirst in Neuro-ICU patients was 47.4%. Intense thirst in Neuro-ICU patients was predicted by dysphagia (odds ratio [OR] = 1.436, 95% confidence interval [CI]:1.063-1.941), open mouth breathing (OR = 2.201, 95% CI:1.041-4.656), high glucose (OR = 2.584, 95% CI:1.097-6.087), xerostomia (OR = 3.049, 95% CI:1.950-4.767) (all p < .05). The intensity of thirst was dynamically changing and the incidence of intense thirst in Neuro-ICU patients was relatively high. Timely assessment of Neuro-ICU patients' thirst severity and identification of those at high risk can ensure the implementation of effective interventions based on patients' characteristics. Thirst is a pervasive distressing symptom often reported by critically ill patients. This study revealed that the clinical nurses need to enhance their focus on dynamic change of thirst, which is helpful for improving the efficiency of bundled thirst interventions at the suitable time.

Food poisoning causes and prevention and what to know about hygiene

Food-borne diseases are the most common health problems globally, and they are particularly common in Third World countries like India due to poor public sanitation and hygiene. Broadly speaking, food poisoning refers to any illness brought on by eating food that contains bacteria or non-bacterial substances. Stated differently, it's an acute instance of gastroenteritis caused by ingesting chemicals-contaminated food or drink, animal or plant-derived poisons, or living microbes and their toxins. Acute gastroenteritis is one of the leading causes of morbidity and mortality. The most vulnerable are newborns and young children. The clinical symptoms of a foodborne infection are determined by the pathogenic mechanisms that underlie it. The main symptoms are headache, nervousness, intense thirst, abrupt vomiting, diarrhea, colicky discomfort, cold, clammy skin, slow heartbeat, rigours, and cramps. The provision of clean, drinkable water, appropriate disposal of human and animal sewage with isolation from water supplies, and fundamental food hygiene standards are all very effective ways to prevent the development of these disorders.

Schaftoside from Plumula nelumbinis mitigates “Shanghuo” by inhibiting low‐grade inflammation, diminishing oxidative stress, and enhancing energy metabolism

AbstractThe study was focused on the therapeutic potential of schaftoside (SS), a key bioactive compound found in Plumula nelumbinis, in the context of “Shanghuo,” an excessive internal heat condition induced by the overconsumption of capsaicin. “Shanghuo” in traditional Chinese medicine is characterized by symptoms like skin and mucous membrane redness, swelling, fever, and discomfort. It is commonly used to describe symptoms such as intense thirst, constipation, and a rapid or surging pulse. In modern medicine, it is associated with various factors, including dietary irritants, stress, gut microbiota imbalances, and immunological issues. The concept of Yin–Yang balance is pivotal in the theory of traditional Chinese medicine. Yin embodies elements of stability and inhibition, whereas Yang is indicative of vitality and assertiveness. Excessive capsaicin intake can also trigger “Shanghuo” symptoms by disrupting the body's balance of “Yin and Yang.” In the present study, we isolated SS from P. nelumbinis and performed in vitro antioxidant assays. SS exhibited a concentration‐dependent increase in antioxidant activity, indicating its potential to combat oxidative stress. In animal experiments, rats exposed to a high dose of capsaicin showed elevated levels of inflammatory markers and reduced antioxidant levels. SS effectively mitigated these imbalances, restored antioxidant enzyme activity, and reduced inflammation. Furthermore, capsaicin‐treated rats showed decreased energy metabolism and altered gut microbiota. SS treatment enhanced energy metabolism and increased the abundance of intestinal flora, highlighting its potential to restore metabolic balance. In conclusion, SS from P. nelumbinis shows promise in alleviating “Shanghuo” induced by excessive capsaicin intake.

The efficacy and safety of modified ultraearly oral hydration for alleviating thirst in patients after thoracoscopic surgery: a prospective randomized controlled trial

ObjectivePostoperative fasting following thoracoscopic surgery can cause intense thirst and oral discomfort. However, there is currently no research on ultraearly oral hydration (UEOH) in middle-aged or elderly patients after thoracoscopic surgery. The aim of this study was to investigate the effectiveness and safety of UEOH for improving oral discomfort after thoracoscopic surgery.MethodsThis single-center prospective double-blind randomized controlled trial was conducted from April 2022 to November 2023. A total of 64 middle-aged and elderly patients who underwent the first thoracoscopic surgery on the day were enrolled at our institution. Postoperatively, in the Postanesthesia Care Unit (PACU), patients were randomly assigned at a 1:1 ratio to either the UEOH group or the standard care (SC) group. The primary outcome was the patient’s thirst score at 6 h after surgery. Secondary outcomes included the incidence of postoperative oral discomfort; pain scores; the occurrence of adverse reactions such as nausea, vomiting, regurgitation and aspiration; anxiety scores on the first postoperative day; the time to first flatus; and recovery satisfaction scores.ResultsThe demographic and surgical characteristics were similar between the two groups. Patients in the UEOH group had lower thirst scores 6 h after surgery than did those in the SC group(16.1 ± 6.70 vs. 78.4 ± 8.42, P < 0.01). The incidence of postoperative oral discomfort (P < 0.01), anxiety scores on the first postoperative day (P<0.05), and time to first flatus (P<0.05) were better in the UEOH group. Additionally, the incidences of adverse reactions, such as postoperative nausea, vomiting, regurgitation and aspiration, were similar between the two groups (P>0.05).ConclusionFor middle-aged and elderly patients undergoing thoracoscopic surgery, the use of a modified UEOH protocol postoperatively can improve thirst and promote gastrointestinal recovery without increasing complications.Trial registrationThis single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 07/12/2023 with the registration number ChiCTR2300078425.

Understanding and addressing the cholera outbreak in Zambian communities

Cholera is a bacterial infection caused by the Vibrio cholera bacterium, primarily transmitted through contaminated water and food. The effects of cholera on health can be severe and potentially life-threatening. The hallmark symptom of cholera is acute watery diarrhea, which can lead to rapid dehydration and electrolyte imbalance. As the body loses large amounts of fluid and essential salts, individuals with cholera often experience intense thirst, dry mucous membranes, sunken eyes, and lethargy. If left untreated, the dehydration can progress rapidly, causing a dangerous condition known as choleric dehydration and in most cases death. Hence, the study was conducted to analyze the effects of cholera on health in selected communities of Lusaka district in Zambia. The study employed both qualitative and quantitative methods and a descriptive survey design that sampled 42 participants purposively and conveniently. Data was obtained from the respondents by means of questionnaires and record reading. The data was analyzed by the use of software; Statistical Package for Social Sciences (version 26) and Microsoft Excel (version 16). Frequency tables, graphs, figures, and pie charts were also used to analyze the data. The findings revealed that the effect of cholera on health extends beyond dehydration, affecting various organ systems. Severe cases may lead to hypovolemic shock, characterized by a significant drop in blood pressure and inadequate perfusion of organs. The study also found that Cholera outbreaks pose significant public health challenges, particularly in areas with inadequate sanitation and limited access to clean water. The study therefore recommended that since cholera is highly contagious, primarily through contaminated water and food, those affected should be isolated to prevent the spread of the bacteria. Additionally, Proper hygiene, such as regular handwashing, is essential to reduce the risk of transmission.

The association between anti-glutamic acid decarboxylase IgG and hemoglobin A1C among newly diagnosed type 1 diabetes of some Iraqi children in Karbala City

Abstract Background: Type 1 diabetes mellitus (T1DM) is brought on by immune system dysfunction intolerance, invasion of beta cells by autoreactive immunological T cells, degradation of beta cell activity and survival, and extended exogenous insulin treatment. One of the circulation autoantibodies against antigens of pancreatic cell that produce insulin is glutamic acid decarboxylase (GAD IgG antibody) that indicate the stress and/or death of the islet cell in T1D. A blood glucose monitoring test called hemoglobin A1C (HbA1c) is used to determine the average blood sugar level over three months (February, March, and April of 2022). Objective: The purpose of this study is to assess the frequency of anti-GAD IgG and HbA1c in T1DM children, as well as their correlation. Materials and Methods: Seventy individuals with new-onset T1DM (confirmed by clinical signs, including increased urination, intense hunger, intense thirst, and abrupt weight loss, along with a random blood sugar test that is higher than 200 mg/dL and a fasting blood sugar test that is higher than 126 mg/dL) are male and female, ranging in age from 1 to 12 years. Blood was drawn for the biochemical and immunological tests (including HbA1c, fasting blood sugar, C-peptide, anti-islets antibodies, and anti-GAD antibodies). Results: Ninety-four percent of the T1DM patients had positive anti-GAD IgG with a mean concentration of 147 IU/mL, and 6% had negative anti-GAD IgG with a mean value of 9 IU/mL. At the same time, the findings of the current study’s calculation of HbA1c levels revealed that individuals with newly diagnosed T1DM had a total mean average of HbA1c of 10.53. Conclusion: Specifically in T1D that had arisen in extremely young children, autoimmunity was discovered to take part in the glycemic index expressed by glycated hemoglobin average.

The Role of Zinc in Cancer Patients Suffering From Diabetic Disease or Hyperglycaemia and the Impacts in the New Immunotherapy Protocols

Diabetes is a harmful metabolic disease (fasting hyperglycemia, intense thirst, mainly nocturnal diuresis, etc.) which afflicts millions of people worldwide and is correlated with environmental pollution and poor diet. The hyperglycemia of diabetic disease, supported by insulin resistance and hyperinsulinemia, is closely related to an increase in oncological, cardiovascular and chronic-degenerative diseases and to a worsening of any responses to therapeutic protocols. Our work proposes an insight into the lack of therapeutic response to immunotherapy and/or chemotherapy protocols in diabetic or hyperglycemic cancer patients. Lack of therapeutic response, in fact, occurs when a patient does not respond to a certain pathology because the body is unable to produce or activate specific lymphocytes and antibodies towards that disease. We argue that the lack of therapeutic response can be caused by deficiencies of trace elements such as Zinc, Copper, Manganese and Cobalt etc. Which help our body to improve its health condition and aggravated by toxic substances such as heavy metals, PCBs and other environmental pollutants. It therefore becomes essential to dose these substances in the various biological matrices (blood, hair, urine, modified tissues, etc.) and in the tumor to adequately deal with the neoplastic disease and reduce the possibility of a lack of therapeutic response.

Best Practices in Oral Care.

Best Practices in Oral Care.

Abstract #1408214: Severe Hypernatremia Due to Central Diabetes Insipidus with Adipsia: Challenges in Management

Hypernatremia (serum sodium >145meq/L) is independently associated with increased mortality as high as 40-60%. Mortality correlates with the rapidity of the rise in sodium and the degree of severity. Central Diabetes Insipidus (DI) associated with adipsia pose a unique management challenge, leading to recurrent hospital admissions due to hypernatremia. We report, a patient with Central DI who presented with severe hypernatremia following desmopressin non-compliance and inadequate water intake. A 25-year female with a past history of obstructive hydrocephalous underwent ventriculoperitoneal shunt revision and had a complicated hospital course including new onset Central DI. The patient was discharged on desmopressin and a serum sodium of 148 meq/L. She presented to the hospital 3 days later with altered mentation, dehydration, and a heart rate of 124bmp. Other vital signs were stable. CT head showed no acute intracranial abnormalities. Labs showed: serum sodium 190meq/L, serum osmolality 393mOsm/kg, urine sodium 44mEq/L, and urine osmolality 878mEq/L. She initially received IV isotonic fluid, and IV DDAVP, and later started on hypotonic fluid and oral DDAVP. Labs were monitored every 6 hours. The patient didn’t have a sense of thirst, didn’t like the taste of water, and had a suboptimal response to oral DDAVP. Multiple measures were taken to stabilize her serum sodium: switched to DDAVP Nasal spray, placed alarms on her cell phone as a reminder to drink water, flavored powders were used to make the water palatable, and provided education on the importance of DDAVP, adequate water intake, and outpatient follow-ups. The patient was safely discharged home after demonstrating the ability to maintain normal serum sodium on oral fluid intake and self-administered nasal DDAVP. Thirst is a critical adaptive mechanism to protect against hypernatremia. Intense thirst may be present initially, but it dissipates as hypernatremia progresses and is absent in patients with adipsia. Destruction or improper functioning of osmoreceptors in the hypothalamus that controls the thirst mechanism can result in adipsia; this may result from a congenital malformation or acquired as in the case of stroke, trauma, or infection. It was most likely secondary to multiple intracranial procedures in our patient. This case also highlights cerebral adaptation to chronic hypernatremia. Brain shrinkage is countered by an adaptive response initiated promptly and consists of solute gain (initial uptake of sodium and potassium, followed by the later accumulation of osmolytes; mainly myoinositol and the amino acid glutamine) by the brain that tends to restore lost water. This response leads to the normalization of brain volume and accounts for the milder symptoms of hypernatremia that develops slowly, as seen in this patient. In conclusion, patients with Central DI associated with adipsia can pose a significant management challenge. This case highlights the importance of addressing all the barriers that affect patients’ compliance with DDAVP and ensuring adequate hydration to prevent recurrent hospital admission and associated morbidity and mortality.

An Unusual Cause of Acidosis in a Man With Clostridium difficile Colitis

An Unusual Cause of Acidosis in a Man With Clostridium difficile Colitis

Effects of a spray-based oropharyngeal moisturising programme for patients following endotracheal extubation after cardiac surgery: A randomised, controlled three-arm trial

BackgroundWhen a patient emerges from cardiac surgery, they may experience intense thirst and discomfort or even impaired swallowing after endotracheal extubation. This may lead to feelings of suffocation, desperation, fear, and anxiety. Although thirst relief and dysphagia prevention share similar mechanisms, there is limited evidence for a combined intervention to alleviate thirst and prevent dysphagia. Furthermore, no studies to date have targeted postoperative cardiac patients. ObjectiveTo evaluate the safety, feasibility, and effects of a spray-based oropharyngeal moisturising programme for cardiac surgery patients following endotracheal extubation. DesignA randomised, controlled three-arm trial was conducted from October 2017 to December 2019. SettingTertiary medical centre cardiac care unit. ParticipantsParticipants (N = 145) were patients who underwent cardiac surgery and received mechanical ventilation. MethodsParticipants were randomly assigned to one of three groups: a four-part programme offering spray-based therapy with either a constant low-temperature cold spray (programme A; n = 47) or low-to-normal temperature spray (programme B; n = 49), or those that received usual care (control group; n = 49). Control group patients who complained of thirst were given wet cotton swabs to moisten their mouths. The primary outcomes included discomfort and various levels of thirst intensity; secondary outcomes included dysphagia and adverse events. Outcomes were evaluated at Time 0 (baseline), Time 1 (3 h), Time 2 (6 h) and Time 3 (96 h) post intervention. Repeated-measures analyses was performed using generalised estimating equations. ResultsThe baseline evaluation indicated no significant differences between the groups. Participants (average age: 55 years; 53.8% men) underwent cardiac surgery for; valvular heart disease (64.8%), coronary atherosclerotic heart disease (25.5%), or aortic dissection (9.7%). Baseline scores indicated moderately severe thirst (6.24±1.57) and discomfort (9.88±2.23). Post intervention, the thirst intensity in the intervention groups was significantly lower than that of the control group (p<0.001). The generalised estimating equation analysis showed no significant difference in reduced thirst intensity between programmes A and B (adjusted β=0.08, 95% CI: −0.59–0.76, p = 0.810) when controlling for intervention condition and time. Comparable results were found for reduced thirst discomfort (adjusted β=0.36, 95% CI: −0.66–1.38, p = 0.493). The three groups showed no significant differences for dysphagia frequency. No observable adverse events were reported during the intervention period. ConclusionsA spray-based oropharyngeal moisturising programme is a practical and effective intervention to alleviate patient thirst after cardiac surgery and tracheal intubation that could be integrated into comfort care for post-surgical patients’ critical care management.Tweetable abstract: A spray-based oropharyngeal moisturising programme for cardiac surgery recipients following endotracheal extubation may alleviate thirst.

Thirst and factors associated with thirst in hospitalized patients with heart failure in China

BackgroundThirst is a distressing symptom and increases burden of the patients with heart failure (HF). Knowledge about thirst in HF patients is still not clear in China. ObjectiveTo describe thirst intensity, distress, frequency, and duration and to identify factors associated with thirst intensity in hospitalized HF patients in China. MethodsA cross-sectional descriptive study was conducted in two public hospitals in Shanghai, China. Patients were recruited in cardiology wards. Sociodemographic and clinical data were collected by the social-demographic and disease-related questionnaire. Thirst was assessed by Visual Analog Scale (VAS, 0–100 mm), Thirst Distress Scale for HF patients (scores 8 to 40) and three questions about thirst frequency and duration. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. ResultsFour hundred and thirty-one patients participated in this study. Their mean (SD) thirst intensity was 47 (±22) mm, and the thirst distress was 21(±4). It was found that 75% patients had moderate to severe feeling in thirst intensity and 73% in distress. Most patients experienced thirst several times a week (33%) or several times a month (38%). Most patients (88%) felt thirst for one hour or less. The most intense thirst occurred in the morning (26%), afternoon (19%) and before sleeping (16%). Factors associated with thirst were omeprazole, renal insufficiency, coronary heart disease, high NYHA class and low room humidity. No links were found between physiological indicators of HF (ProBNP) and thirst. ConclusionsHF patients have strong sense of thirst. However, it is rarely identified by healthcare professionals. It is crucial for healthcare providers to keep an eye on patients’ thirst symptoms. More attention should be paid to patients with thirst risk factors to minimize the discomfort of thirst.

FOOD POISONING: CAUSES, ITS EFFECTS AND CONTROL

Food poisoning is also known as a foodborne illness caused by the consumption of contaminated food or water containing various bacteria, viruses, protozoa, non-microbial agents like vegetable origin or animal origin, and also toxins of biochemical or chemical nature. The primary source of foodborne illness is bacteria (66%), chemicals (26%), parasites (4%), and viruses (4%). Nowadays more people have died from diarrheal diseases caused by the consumption of contaminated food and water. The symptoms that occur through food poisoning are headache, giddiness, colicky pain, cold and clammy skin, intense thirst, acute vomiting, diarrhea, slow pulse, rigors, abdominal pain, hepatic, and cramps. To avoid food poisoning we should consume healthy food, fresh vegetables, fresh fruits, purified water and avoid junk food which is easily available in the market. Viruses that are present on water or surfaces can be removed through using an ultraviolet light.

FOOD POISONING: CAUSES, ITS EFFECTS AND CONTROL

Food poisoning is also known as a foodborne illness caused by the consumption of contaminated food or water containing various bacteria, viruses, protozoa, non-microbial agents like vegetable origin or animal origin, and also toxins of biochemical or chemical nature. The primary source of foodborne illness is bacteria (66%), chemicals (26%), parasites (4%), and viruses (4%). Nowadays more people have died from diarrheal diseases caused by the consumption of contaminated food and water. The symptoms that occur through food poisoning are headache, giddiness, colicky pain, cold and clammy skin, intense thirst, acute vomiting, diarrhea, slow pulse, rigors, abdominal pain, hepatic, and cramps. To avoid food poisoning we should consume healthy food, fresh vegetables, fresh fruits, purified water and avoid junk food which is easily available in the market. Viruses that are present on water or surfaces can be removed through using an ultraviolet light.

Regional brain responses associated with using imagination to evoke and satiate thirst

In response to dehydration, humans experience thirst. This subjective state is fundamental to survival as it motivates drinking, which subsequently corrects the fluid deficit. To elicit thirst, previous studies have manipulated blood chemistry to produce a physiological thirst stimulus. In the present study, we investigated whether a physiological stimulus is indeed required for thirst to be experienced. Functional MRI (fMRI) was used to scan fully hydrated participants while they imagined a state of intense thirst and while they imagined drinking to satiate thirst. Subjective ratings of thirst were significantly higher for imagining thirst compared with imagining drinking or baseline, revealing a successful dissociation of thirst from underlying physiology. The imagine thirst condition activated brain regions similar to those reported in previous studies of physiologically evoked thirst, including the anterior midcingulate cortex (aMCC), anterior insula, precentral gyrus, inferior frontal gyrus, middle frontal gyrus, and operculum, indicating a similar neural network underlies both imagined thirst and physiologically evoked thirst. Analogous brain regions were also activated during imagined drinking, suggesting the neural representation of thirst contains a drinking-related component. Finally, the aMCC showed an increase in functional connectivity with the insula during imagined thirst relative to imagined drinking, implying functional connectivity between these two regions is needed before thirst can be experienced. As a result of these findings, this study provides important insight into how the neural representation of subjective thirst is generated and how it subsequently motivates drinking behavior.

The use of mentholated popsicle to reduce thirst during preoperative fasting: A randomised controlled trial.

To compare mentholated popsicle with usual care (absolute fasting) in the change of thirst intensity and discomfort of patients in the preoperative fasting. Thirst is defined as the desire to drink water, and it is considered to be a multifactorial symptom. In the preoperative fasting, the patient may experience intense thirst, often for a long time, that can lead to feelings of suffocation, desperation, fear and anxiety. A randomised controlled trial. Forty patients, aged between 18-60years, were randomised to mentholated popsicle group or absolute fasting group (twenty in each). The primary outcomes were thirst intensity, evaluated by a numeric scale ranging from 0 (no thirst)-10 (the worst possible thirst), and discomfort from thirst (evaluated by the Perioperative Thirst Discomfort Scale), both measured twice (baseline and after 20min of intervention). The CONSORT checklist was used to report this study. Mean age was similar in both groups (38years in the mentholated popsicle group and 39 in the absolute fasting group). At baseline, the mentholated popsicle group had higher median for the scales of intensity (6.5) and discomfort (7.5) from thirst than the absolute fasting group (5.0 and 5.0, respectively). At the end of 20min, the popsicle group had a statistically significant decrease in intensity and discomfort from thirst (median decreases of 5.0 and 7.0 points, respectively) when compared to the absolute fasting group (median increases of 0.5 and 1.0 points, respectively). The use of mentholated popsicle decreased the intensity and discomfort from thirst, and it is a viable strategy for the management of thirst in the preoperative fasting. In the preoperative fasting, making mentholated popsicles available to patients is an easy strategy to manage thirst, which might lead to better care.

Association of Persistent Intense Thirst With Delirium Among Critically Ill Patients: A Cross-sectional Study

ContextThirst is a prevalent distressing symptom often reported by patients in the intensive care unit (ICU). Little is known about the association of thirst with delirium. ObjectiveWe aimed to investigate the relationship between thirst and delirium. MethodsThis retrospective cross-sectional study enrolled 401 patients who were evaluated for thirst intensity in the ICU between March 2017 and October 2017. We assessed thirst intensity on a scale of 0–10 (with 10 being the worst) and defined intense thirst as a score ≥8. If intense thirst persisted for more than 24 hours, we defined it as persistent intense thirst. Delirium was screened using the Intensive Care Delirium Screening Checklist. Propensity score matching and inverse probability of treatment weighting analyses were performed. ResultsOf 401 patients, 66 (16.5%) had intense thirst sensation for more than 24 hours. After matching, patients with persistent intense thirst showed an increased risk for delirium compared with those without persistent intense thirst (odds ratio, 4.95; 95% confidence interval, 2.58–9.48; P < 0.001). Propensity score weighted logistic regression analysis also indicated that persistent intense thirst was significantly associated with delirium (odds ratio, 5.74; 95% confidence interval, 2.53–12.99; P < 0.001). ConclusionIntense thirst persisting for more than 24 hours was associated with increased risk for delirium.

Thirst-Dependent Activity of the Insular Cortex Reflects its Emotion-Related Subdivision: A Cerebral Blood Flow Study

Recent studies investigating neural correlates of human thirst have identified various subcortical and telencephalic brain areas. The experience of thirst represents a homeostatic emotion and a state that slowly evolves over time. Therefore, the present study aims at systematically examining cerebral perfusion during the parametric progression of thirst. We measured subjective thirst ratings, serum parameters and cerebral blood flow in 20 healthy subjects across four different thirst stages: intense thirst, moderate thirst, subjective satiation and physiological satiation. Imaging data revealed dehydration-related perfusion differences in previously identified brain areas, such as the anterior cingulate cortex, the middle temporal gyrus and the insular cortex. However, significant differences across all four thirst stages (including the moderate thirst level), were exclusively found in the posterior insular cortex. The subjective thirst ratings over the different thirst stages, however, were associated with perfusion differences in the right anterior insula. These findings add to our understanding of the insular cortex as a key player in human thirst – both on the level of physiological dehydration and the level of the subjective thirst experience.