Non-Cochrane · intervention · PM42266163
Effects of Non-Pharmacological Interventions on Degree of Thirst and Oral Mucosal Moisture in Critically Ill Patients: A Systematic Review and Meta-Analysis.
Shen Xiaowen, Wang Rong, Zhao Lvmei, et al. · Nursing in critical care · 2026 · PubMed · doi:10.1111/nicc.70541
Findings
193 findings
| Population | ||||
|---|---|---|---|---|
| Critically ill adult ICU patients | Bundle care | Drink little ice water | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.33 [-4.89, 2.24] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Mint water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.79 [-3.94, 0.35] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Mint water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.78 [-3.43, 1.88] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Mint water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.47 [-3.94, 3.01] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Usual care | Thirst intensity (NRS/VAS) Intensive care units · Intubated patients (subgroup network of 12 studies) | mint water spray and ice cubes in mouth showed statistically significant differences compared with usual care (intubated subgroup) GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Menthol lozenges | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.65 [-5.19, 1.88] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Menthol lozenges | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.33 [-4.80, 4.14] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Menthol lozenges | Thirst intensity (NRS/VAS score) Intensive care unit | SMD 0.14 [-3.31, 3.58] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Dip a cotton swab in ice water | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.71 [-5.40, 1.97] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Dip a cotton swab in ice water | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.39 [-4.98, 4.21] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2°C–8°C Chinese medicine water spray | Usual care | Objective oral mucosa moisture (OOMS) Intensive care units | SMD 0.36 [-1.51, 2.23] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | Usual care | Thirst distress (TDS) Intensive care units | SMD 3.75 [1.17, 6.32] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Dip a cotton swab in ice water | Thirst intensity (NRS/VAS score) Intensive care unit | SMD 0.08 [-3.38, 3.54] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Dip a cotton swab in ice water | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.06 [-4.63, 4.51] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Psyllium spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.77 [-5.01, 1.47] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Lemonade spray | Usual care | Thirst distress (TDS) Intensive care units | SMD 0.48 [-1.95, 2.91] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Psyllium spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.44 [-4.68, 3.80] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Psyllium spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD 0.02 [-2.78, 2.83] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Psyllium spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.11 [-4.33, 4.10] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 20°C–24°C Chinese medicine water spray | Usual care | Thirst intensity (NRS/VAS) Intensive care units | SMD 1.05 [-2.17, 4.28] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Psyllium spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.05 [-4.34, 4.23] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Ice cubes in mouth | Thirst distress (TDS score) Intensive care unit | SMD -0.69 [-3.36, 1.99] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Ice cubes in mouth | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.87 [-4.69, 0.94] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Ice cubes in mouth | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.55 [-4.47, 3.38] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Ice cubes in mouth | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.08 [-2.69, 2.52] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Ice cubes in mouth | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.22 [-4.12, 3.68] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Ice cubes in mouth | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.16 [-4.06, 3.74] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Ice cubes in mouth | Thirst distress (TDS score) Intensive care unit | SMD -0.79 [-3.88, 2.29] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Ice cubes in mouth | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.11 [-3.70, 3.49] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.09 [-5.74, 1.56] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.33 [-3.47, 0.80] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.76 [-5.33, 3.80] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.30 [-3.72, 3.12] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.90 [-3.77, -0.03] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.44 [-4.98, 4.10] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.38 [-4.80, 4.05] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.32 [-4.58, 3.93] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -2.62 [-4.71, -0.52] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | 2-8 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.22 [-4.08, 3.65] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -5.48 [-8.47, -2.48] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.45 [-5.96, 1.07] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.12 [-5.57, 3.34] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.65 [-3.57, 2.27] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -4.70 [-8.06, -1.33] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.79 [-5.22, 3.64] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.73 [-5.15, 3.69] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.68 [-4.68, 3.32] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -5.58 [-8.95, -2.21] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.57 [-4.37, 3.23] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -4.79 [-8.17, -1.41] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | Saline spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.35 [-4.74, 4.04] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.54 [-4.46, -0.62] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Ice water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.04 [-1.62, 1.54] GRADE not reported Studies not reported |
| Critically ill adult ICU patients (non-intubated subgroup) | Bundle care | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit · Non-intubated subgroup (12 studies) | SMD -3.39 [-6.04, -0.75] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.21 [-4.56, 2.13] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.75 [-2.18, 0.69] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Ice water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.60 [-1.80, 0.59] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.89 [-4.20, 2.43] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.83 [-3.97, 2.32] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.77 [-3.68, 2.14] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.67 [-2.97, 1.64] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Ice water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.32 [-2.85, 0.20] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.45 [-3.56, 2.66] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | Ice water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.09 [-3.20, 3.01] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.75 [-6.28, 0.79] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.42 [-5.89, 3.05] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.95 [-4.40, 2.49] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.09 [-5.54, 3.36] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.03 [-5.60, 3.54] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.98 [-5.19, 3.24] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.87 [-4.77, 3.03] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.65 [-5.19, 3.89] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.30 [-4.73, 4.13] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Moisture gel | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.21 [-3.52, 3.11] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.21 [-6.02, -0.40] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -2.21 [-5.08, 0.66] GRADE not reported Studies not reported |
| Critically ill adult ICU patients (non-intubated subgroup) | Bundle care | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit · Non-intubated subgroup (12 studies) | SMD -5.61 [-9.57, -1.66] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.89 [-5.81, 2.04] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -1.43 [-4.69, 1.82] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.42 [-3.61, 0.77] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.56 [-5.45, 2.34] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.50 [-5.35, 2.36] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.44 [-4.90, 2.01] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -2.32 [-5.58, 0.94] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.34 [-4.48, 1.80] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -1.52 [-4.80, 1.75] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.12 [-4.94, 2.70] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.77 [-3.69, 2.15] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.67 [-2.90, 1.55] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -2.42 [-4.59, -0.26] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Moisture gel | Lemonade spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.47 [-4.36, 3.43] GRADE not reported Studies not reported |
| Critically ill adult ICU patients (non-intubated subgroup) | Bundle care | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit · Non-intubated subgroup (12 studies) | SMD -4.82 [-8.12, -1.51] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Normal temperature water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.27 [-1.98, 1.45] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Normal temperature water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.42 [-2.90, 2.06] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.21 [-5.46, -0.96] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.88 [-5.42, 1.66] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.42 [-3.07, 0.24] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Normal temperature water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.83 [-2.20, 0.54] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.55 [-5.07, 1.96] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.49 [-4.99, 2.00] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.44 [-4.52, 1.64] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Normal temperature water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.53 [-3.45, 2.39] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.33 [-4.00, 1.33] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Normal temperature water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.55 [-3.78, 0.67] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.12 [-4.57, 2.34] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.76 [-3.94, 2.42] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Normal temperature water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.23 [-1.84, 1.39] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.67 [-2.18, 0.84] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Normal temperature water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.63 [-2.58, 1.31] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Moisture gel | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -0.46 [-3.98, 3.05] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Lemonade spray | Normal temperature water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD 0.00 [-2.28, 2.29] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -4.50 [-6.12, -2.88] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.97 [-2.00, 0.06] GRADE not reported Studies not reported |
| Critically ill adult ICU patients (non-intubated subgroup) | Bundle care | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit · Non-intubated subgroup (12 studies) | SMD -4.50 [-6.18, -2.82] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -1.73 [-3.26, -0.20] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.17 [-6.35, 0.01] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -0.95 [-3.12, 1.22] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.54 [-2.72, -0.35] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.71 [-4.11, -1.30] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.85 [-5.99, 0.30] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.79 [-6.10, 0.53] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.73 [-5.54, 0.08] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -1.84 [-4.01, 0.34] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -2.25 [-4.20, -0.31] GRADE not reported Studies not reported |
| Critically ill adult ICU patients (intubated subgroup) | Ice cubes in mouth | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit · Intubated subgroup (12 studies) | Compared with the usual care group, both mint water spray and ice cubes in mouth showed statistically significant differences. GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.63 [-4.93, -0.32] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -1.04 [-3.23, 1.15] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.41 [-5.68, 0.87] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.05 [-5.18, 1.07] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -1.94 [-3.05, -0.84] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.93 [-2.13, 0.27] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.96 [-3.00, -0.92] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Moisture gel | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.75 [-4.90, 1.39] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Lemonade spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.29 [-3.58, 1.01] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -1.31 [-3.26, 0.64] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.70 [-2.07, 0.67] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Usual care | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -1.29 [-2.85, 0.27] GRADE not reported Studies not reported |
| Critically ill adult ICU patients (non-intubated subgroup) | Bundle care | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit · Non-intubated subgroup (12 studies) | SMD -6.46 [-10.61, -2.30] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -5.55 [-9.16, -1.95] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Drink little ice water | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -4.23 [-8.75, 0.30] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | 20-24 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.24 [-2.10, 1.62] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.76 [-7.14, -0.39] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Menthol lozenges | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.90 [-8.40, 0.60] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Dip a cotton swab in ice water | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.84 [-8.23, 0.55] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.79 [-8.00, 0.43] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.68 [-7.51, 0.15] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | 20-24 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.96 [-3.05, 1.13] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 2-8 C Chinese medicine water spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.46 [-6.61, -0.32] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Saline spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.11 [-7.46, 1.24] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -3.01 [-6.08, 0.05] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Moisture gel | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.81 [-7.31, 1.69] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Lemonade spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.34 [-6.12, 1.44] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | 20-24 C Chinese medicine water spray | Thirst intensity (NRS/VAS score) Intensive care unit | SMD -2.35 [-5.76, 1.06] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Psyllium spray | Thirst distress (TDS score) Intensive care unit | SMD -0.11 [-2.55, 2.34] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Bundle care | Thirst distress (TDS score) Intensive care unit | SMD -0.21 [-2.10, 1.68] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Bundle care | Thirst distress (TDS score) Intensive care unit | SMD -0.11 [-2.77, 2.56] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Glycerol saline spray | Thirst distress (TDS score) Intensive care unit | SMD -0.81 [-2.96, 1.33] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Glycerol saline spray | Thirst distress (TDS score) Intensive care unit | SMD -0.71 [-3.95, 2.54] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Bundle care | Glycerol saline spray | Thirst distress (TDS score) Intensive care unit | SMD -0.60 [-3.45, 2.26] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Glycerol saline spray | Thirst distress (TDS score) Intensive care unit | SMD -0.18 [-3.07, 2.72] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Ice cubes in mouth | Thirst distress (TDS score) Intensive care unit | SMD -0.90 [-3.36, 1.56] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Ice cubes in mouth | Thirst distress (TDS score) Intensive care unit | SMD -0.27 [-3.20, 2.67] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Glycerol saline spray | Ice cubes in mouth | Thirst distress (TDS score) Intensive care unit | SMD -0.09 [-3.34, 3.17] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Mint water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.99 [-3.42, 1.44] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Psyllium spray | Mint water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.88 [-3.05, 1.28] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Mint water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.36 [-3.27, 2.56] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Glycerol saline spray | Mint water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.18 [-3.42, 3.06] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Mint water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.72 [-2.66, 1.22] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Mint water spray | Thirst distress (TDS score) Intensive care unit | SMD -0.09 [-3.17, 2.99] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Glycerol saline spray | Usual care | Thirst distress (TDS score) Intensive care unit | SMD -1.13 [-3.54, 1.28] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -1.79 [-4.70, 1.12] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Glycerol saline spray | Lemonade spray | Thirst distress (TDS score) Intensive care unit | SMD -1.61 [-3.77, 0.55] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -5.69 [-8.01, -3.37] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -5.05 [-8.08, -2.02] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Glycerol saline spray | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -4.88 [-8.04, -1.72] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Lemonade spray | Saline spray | Thirst distress (TDS score) Intensive care unit | SMD -3.26 [-6.44, -0.09] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | 4 C black plum licorice spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.59 [-2.69, 1.51] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | Mint water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.13 [-2.00, 1.74] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | 20-24 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.37 [-2.39, 1.66] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice cubes in mouth | Bundle care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.28 [-3.48, 0.91] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | Bundle care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.69 [-2.83, 1.44] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Mint water spray | Bundle care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.57 [-2.13, 1.00] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 20-24 C Chinese medicine water spray | Bundle care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.33 [-2.45, 1.80] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | Ice water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.73 [-2.17, 0.70] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 20-24 C Chinese medicine water spray | Ice water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.37 [-1.79, 1.06] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | Normal temperature water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.96 [-3.13, 1.20] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 20-24 C Chinese medicine water spray | Normal temperature water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -0.59 [-2.75, 1.56] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.66 [-3.54, 0.21] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 20-24 C Chinese medicine water spray | Usual care | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.30 [-3.16, 0.56] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 4 C black plum licorice spray | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -2.03 [-4.06, 0.00] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | 20-24 C Chinese medicine water spray | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.66 [-3.10, -0.22] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Ice water spray | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.29 [-2.73, 0.14] GRADE not reported Studies not reported |
| Critically ill adult ICU patients | Normal temperature water spray | 2-8 C Chinese medicine water spray | Objective oral mucosal moisture (OOMS) Intensive care unit | SMD -1.07 [-3.23, 1.10] GRADE not reported Studies not reported |
Included primary studies 17
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Can 2023 Effect of menthol lozenges after extubation on thirst, nausea, physiological parameters, and comfort in cardiovascular surgery patients: A… PMID:36812765 | 2023 | 1 other review | not stated | not extracted yet |
| Gungor 2024 Effects of cold spray on thirst, frequency of oral care, and pain of general surgery intensive care unit patients. PMID:38693271 | 2024 | 1 other review | not stated | not extracted yet |
| Lian 2024 The effect of ice-cold water spray following the model for symptom management on postoperative thirst in patients admitted to intensive… PMID:38211420 | 2024 | 1 other review | not stated | not extracted yet |
| Lin 2022 Effects of a spray-based oropharyngeal moisturising programme for patients following endotracheal extubation after cardiac surgery: A… PMID:35421771 | 2022 | 1 other review | not stated | not extracted yet |
| Wang 2023 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Zheng 2025 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Atashi 2018 The Effects of Aloe vera-Peppermint (Veramin) Moisturizing Gel on Mouth Dryness and Oral Health among Patients Hospitalized in Intensive… PMID:30050964 | 2018 | this review only | not stated | not extracted yet |
| Ding 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Puntillo 2014 A randomized clinical trial of an intervention to relieve thirst and dry mouth in intensive care unit patients. PMID:24894026 | 2014 | this review only | not stated | not extracted yet |
| Sayadi 2021 Vitamins, minerals, schoolchildren, and IQ. PMID:2021716 | 1991 | this review only | not stated | not extracted yet |
| Shikhai 2020 Effectiveness of an Intervention Bundle on Thirst Intensity and Dry Mouth among Patients Admitted in Intensive Care Units DOI:10.37506/ijphrd.v11i4.4408 | 2020 | this review only | not stated | not extracted yet |
| Tian 2024 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Yan 2021 Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. PMID:2021718 | 1991 | this review only | not stated | not extracted yet |
| Zhang 2022 Symptom management to alleviate thirst and dry mouth in critically ill patients: A randomised controlled trial. PMID:34119409 | 2022 | this review only | not stated | not extracted yet |
| Zhang Q 2021 DOI:10.3969/j.issn.1672-8467.2021.01.010 | NR | this review only | not stated | not extracted yet |
| Zhang XX 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zhang XX 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients (18 years or older) admitted to ICU for at least 6 h | Critically ill adult ICU patients (n=2605; 26 RCTs; 13 studies in intubated patients; age range 45-71 years) |
| Intervention | Any non-pharmacological intervention aimed at relieving thirst or dry mouth | 15 non-pharmacological interventions (n=26 studies): bundle care; drink little ice water; mint water spray; menthol lozenges; dip a cotton swab in ice water; psyllium spray; ice cubes in mouth; 2°C–8°C Chinese medicine water spray; saline spray; ice water spray; moisture gel; lemonade spray; normal temperature water spray; 20°C–24°C Chinese medicine water spray; usual care; glycerol saline spray; 4°C black plum licorice spray |
| Comparison | Not specified | Usual care, other interventions in the network (e.g. saline spray, ice water spray, lemonade spray, 2°C–8°C Chinese medicine water spray, mint water spray, normal temperature water spray, dip a cotton swab in ice water) |
| Outcomes | Thirst intensity, thirst distress, oral mucosal moisture (validated scales with extractable data) | Thirst intensity (n=25 studies), thirst distress (n=10 studies), objective oral mucosa scale (n=8 studies) |
| Study designs | Randomized controlled trials | 26 randomized controlled trials (3 three-arm trials); China 20, Turkey 2, Iran 2, US 1, India 1 |
| Timing | Not specified | Intervention duration 2 h to 5 days |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |