Yoğun Bakım Hastalarında Susuzluk Yönetimi

Abstract

Susuzluk, yoğun bakım hastalarında sık görülen ancak çoğu zaman yeterince değerlendirilip yönetilemeyen önemli bir semptomdur. Yoğun bakım ünitelerinde hastaların mekanik ventilasyon desteği alması, sıvı kısıtlaması uygulanması, sedatif ve diüretik ilaç kullanımı, oksijen tedavisi ve ağız kuruluğu gibi faktörler susuzluk hissinin artmasına neden olabilmektedir. Susuzluk, hastalarda rahatsızlık, stres ve anksiyete gibi olumsuz deneyimlere yol açarak hasta konforunu ve iyileşme sürecini etkileyebilmektedir. Bu derlemenin amacı yoğun bakım hastalarında susuzluğun nedenleri, değerlendirilmesi ve yönetimine ilişkin literatürün incelenmesidir. Literatürde susuzluğun değerlendirilmesinde hastanın öznel ifadeleri, görsel analog skala gibi ölçüm araçları ve klinik gözlemlerin önemli olduğu belirtilmektedir. Yoğun bakım hastalarında susuzluk yönetiminde ağız bakımının düzenli yapılması, dudakların nemlendirilmesi, buz parçaları veya soğuk uygulamaların kullanılması ve uygun sıvı yönetiminin sağlanması gibi hemşirelik girişimlerinin etkili olduğu bilinmektedir. Sonuç olarak, yoğun bakım hastalarında susuzluk önemli bir semptom olup hasta konforunun artırılması açısından düzenli değerlendirilmesi ve uygun hemşirelik girişimleri ile yönetilmesi gerekmektedir. Yoğun bakım hemşirelerinin susuzluğun erken tanılanması ve yönetiminde aktif rol alması hasta bakım kalitesinin artırılmasına katkı sağlayacaktır.

Keywords

• Hasta konforu
• hemşirelik bakımı
• dehidratasyon
• susuzluk
• yoğun bakım üniteleri.

Thirst Management in Intensive Care Patients

Abstract

Thirst is a common yet often under-recognized and inadequately managed symptom in critically ill patients. In intensive care units, factors such as mechanical ventilation support, fluid restriction, the use of sedative and diuretic medications, oxygen therapy, and oral dryness may contribute to increased thirst sensation. Thirst can lead to negative experiences such as discomfort, stress, and anxiety, thereby affecting patient comfort and the recovery process. The aim of this review is to examine the literature on the causes, assessment, and management of thirst in intensive care patients. The literature indicates that subjective patient reports, measurement tools such as the visual analog scale, and clinical observations play an important role in the assessment of thirst. In the management of thirst, nursing interventions such as regular oral care, moisturizing the lips, the use of ice chips or cold applications, and appropriate fluid management have been shown to be effective. In conclusion, thirst is an important symptom in intensive care patients, and its regular assessment and appropriate management are essential for improving patient comfort. Intensive care nurses play a critical role in the early identification and management of thirst, thereby contributing to the quality of patient care.

Keywords

• Intensive care units
• dehydration
• nursing care
• patient comfort
• thirst

References

1. 1. Adams JD, Myatich AI, McCullough AS. Thirst as an ingestive behavior: A brief review on physiology and assessment. Nutrition and Health. 2020;26(3):271-274.
2. 2. Robayo-Amortegui H, Quintero-Altare A, Florez-Navas C, et al. Fluid dynamics of life: Exploring the physiology and importance of water in the critical illness. Front Med. 2024;11:1368502.
3. 3. Spirig L, Srisanoi K, Kamnoedboon P, Srinivasan M. Efficacy of topical treatments for xerostomia in older adults: A systematic review and meta-analysis. J Dent. 2025;163:106188.
4. 4. Horinouchi M, Sakuramoto H, Fukushima A, Yoshihara S, Kajiwara K, Mukoyama M. Thirst in ICU patients: A scoping review. Cureus. 2025;17(5):e84144.
5. 5. Negro A, Villa G, Greco M, Ciriolo E, Luraschi EL, Scaramuzzi J. Thirst in patients admitted to intensive care units: An observational study. Ir J Med Sci. 2022;191(5):2283–2289.
6. 6. Lin R, Li H, Chen L, He J. Prevalence of and risk factors for thirst in the intensive care unit: An observational study. J Clin Nurs. 2023;32(3-4):465–476.
7. 7. Liang S, He Y, Yuan L, Wu M. Effectiveness of oral cooling in alleviating thirst of ICU patients: A meta-analysis. J Clin Nurs. 2026;35(3):1152–1163.
8. 8. Daley SF, Avva U. Pediatric dehydration. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan 8. Updated 2024. https://www.ncbi.nlm.nih.gov/books/NBK436022

9. 9. Volkert D, Beck AM, Cederholm T, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10–47.
10. 10. Li S, Xiao X, Zhang X. Hydration status in older adults: Current knowledge and future challenges. Nutrients. 2023;15(11):2609.
11. 11. Parkinson E, Hooper L, Fynn J, et al. Low‑intake dehydration prevalence in non‑hospitalised older adults: Systematic review and meta‑analysis. Clin Nutr. 2023;42(8):1510–1520.
12. 12. Puntillo KA, Arai S, Cohen NH, et al. Symptoms experienced by intensive care unit patients at high risk of dying. Crit Care Med. 2010;38(11):2155–2160.
13. 13. Chanques G, Nelson JE, Puntillo KA. Patient symptoms in intensive care units. Intensive Care Med. 2015;41(5):863–865.
14. 14. Bhave G, Neilson EG. Volume depletion versus dehydration: How understanding the difference can guide therapy. Am J Kidney Dis. 2011;58(2):302–309.
15. 15. Adan A. Cognitive performance and dehydration. J Am Coll Nutr. 2012;31(2):71–78.
16. 16. Bartel B, Gau E. Fluid electrolyte management. In: Johnson T, ed. Critical Care Pharmacotherapeutics. Jones & Bartlett Learning; 2013.
17. 17. Lobo DN, Lewington AJP, Allison SP. Basic concepts of fluid and electrolyte therapy. Die Deutsche Bibliothek; 2013.
18. 18. Shepherd A. Measuring and managing fluid balance. Nurs Times. 2011;107:12–16.
19. 19. Sert H. Ödem ve dehidratasyon. In: Eti Aslan F, Olgun N, eds. Yoğun bakım seçilmiş semptom ve bulguların yönetimi. 2016:471.
20. 20. Campbell N. Recognising and preventing dehydration among patients. Nurs Times. 2014;110(46):20–21.
21. 21. Stotts NA, Arai SR, Cooper BA, Nelson JE, Puntillo KA. Predictors of thirst in intensive care unit patients. J Pain Symptom Manage. 2015;49(3):530–538.
22. 22. Xiao M, Zhu F, Zhang Y, et al. Effectiveness of non-pharmacological interventions for thirst in ICU patients: A systematic review and network meta-analysis. BMC Nurs. 2025;24(1):348.
23. 23. Mentes J. Oral hydration in older adults: Greater awareness is needed in preventing, recognizing, and treating dehydration. Am J Nurs. 2006;106(6):40–49.
24. 24. Puntillo K, Arai SR, Cooper BA, et al. Symptoms experienced by intensive care unit patients at high risk of dying. Crit Care Med. 2014;42(4):870–878.
25. 25. Puntillo KA, Stotts NA, Arai SR, Cooper BA. Thirst interventions in intensive care unit patients. Am J Crit Care. 2014;23(6):490–498.
26. 26. Tai J, Guo A, Chen J, et al. Comparative efficacy and safety of non-pharmacological interventions on treatment-induced xerostomia in head and neck cancer patients: A systematic review and network meta-analysis. Front Oncol. 2025;15:1644178.
27. 27. Marín C, Díaz-de-Valdés L, Conejeros C, Martínez R, Niklander S. Interventions for the treatment of xerostomia: A randomized controlled clinical trial. J Clin Exp Dent. 2021;13(2):e104-e111.
28. 28. Li X, Yao L, Yang X. et al. Perceptions, barriers, and challenges of oral care among nursing assistants in the intensive care unit: A qualitative study. BMC Oral Health. 2024;24;235.
29. 29. Aydoğan S, Acaroğlu R. Examination of the effectiveness of the intervention to reduce dry mouth and the feeling of thirst in intensive care patients. Dimens Crit Care Nurs. 2026;45(2):96–102.
30. 30. Shu X, Li S, Pan Z, et al. Effectiveness of non-pharmacological interventions for relieving thirst in intensive care unit patients: A network meta-analysis. Int J Nurs Stud. 2026;173:105245.