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Effects of Non-Pharmacological Interventions on Degree of Thirst and Oral Mucosal Moisture in Critically Ill Patients: A Systematic Review and Meta-Analysis.

10 June 2026·2 min read·Nursing in critical care

Abstract / Summary

Thirst is a common symptom among critically ill patients and may lead to a series of complications. Therefore, effective non-pharmacological strategies to alleviate thirst and manage oral dryness are critical. To assess the effects of non-pharmacological interventions on the degree of thirst and oral mucosal moisture among critically ill patients. A systematic review and network meta-analysis based on PRISMA-NMA. Data sources included Wanfang, CNKI, Sinomed, PubMed, Web of Science, Cochrane Library, Medline, Embase and CINAHL. The network meta-analysis was conducted using the consistency model, and STATA 16.0 was used for analysis. The study was registered on PROSPERO (CRD42024564966). The search period spanned from database inception to June 2025, with 26 articles included, covering 15 thirst interventions and a total of 2605 patients. Bundle care significantly reduced thirst intensity compared with usual care (SMD: -4.50, 95% CI: -6.12 to -2.88). Ice water spray was significantly different from both bundle care (SMD: -1.94, 95% CI: -3.05 to -0.84) and lemonade spray (SMD: -2.42, 95% CI: -4.59 to -0.26) on thirst distress. Compared with 2°C-8°C Chinese medicine water spray, ice cubes in mouth (SMD: -2.62, 95% CI: -4.71 to -0.52) showed a greater improvement in oral mucosal moisture. The Surface Under the Cumulative Ranking curve (SUCRA) indicated that bundle care ranked highest for relieving thirst intensity, while ice cubes in mouth was optimal for improving oral mucosal moisture. This network meta-analysis demonstrates that bundle care is preferred for reducing thirst intensity and ice cubes in mouth is recommended for enhancing oral mucosal moisture. Future well-designed studies are warranted to further validate these conclusions. This study provides recommendations for interventions that nurses can use to improve critically ill patients' thirst level.

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Nursing in critical care

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