All articles included symptomatic HF patients [New York Heart Association (NYHA) classes II–IV]. The third article was a retrospective study based on medical records that reflected nurses' observations and documentation.5 Hence, a total of nine articles were finally used, of which six were quantitative16−21 and three were qualitative22−24 studies (Table 1). Recent Literature The other study examined whether patients with stable HF were able to reduce their fluid and sodium intake without negative effects on thirst, appetite, and quality of life.19 The primary endpoint was to reduce significantly the intake of salt to 2–3 g/day (equal to 5–7.5 g salt) and the water intake to 1.5 L/day. 06/29/2016 12:26 pm ET Updated Dec 06, 2017 Last week I was in the gym feeling strong but still felt something was wrong with my breathing and tiredness. Lippincott Journals Subscribers, use your username or email along with your password to log in. Despite major advances in the treatment of heart failure (HF),1 many patients are burdened by HF symptoms and consequences of treatment, which affect quality of life (QoL).2–4 In daily practice, clinicians and nurses encounter patients with HF who complain of bothersome thirst,5 although this has received little attention in the scientific literature. Hints for fluid control • Use jugs and measuring cups to . Some idea about factors that promote thirst can be obtained from studies on patients with renal failure. Thirst can negatively affect compliance with treatment in HF and weight gain, lead to preoccupation with thirst, and therefore have an impact on the HF patient's QoL. ADH, antidiuretetic hormone. • Fill up a jug of water with your daily fluid allowance each morning and use this to keep track of how much fluid you are drinking throughout the day. Worsening of HF aggravates thirst21 and is also graded higher in patients with the highest NYHA classifications (Figure 4). Acute Decompensated Heart Failure: Treatment Guidelines. and T.J. assessed the methodological quality of the qualitative and quantitative articles prior to inclusion in the review. Published: December, 2014. Wolters Kluwer Health Based on the JBI levels of evidence,15 the studies were ranked according to the research findings most likely to provide valid information on the effectiveness of a treatment/care option. Median thirst intensity ranged from 23 to 75 mm (VAS 0–100 mm). People with Heart Failure often have other conditions, such as diabetes, high blood pressure, COPD, or obesity. Please enable scripts and reload this page. Perceptions of fluid restriction self-care in heart failure. Clinical aspects of changes in water and sodium homeostasis in the elderly. A survey of views and opinions of health professionals managing thirst in chronic heart failure. The different medications can help you feel better. In our hospital, systemic Chinese medicine treatment can help you turn it negative. In healthy persons, thirst can be defined as a sensation and desire that causes a powerful behavioural strive to drink.6 Thirst can be experienced and expressed by patients in various ways.7,8 This feeling may be so intense that the urge to drink becomes irresistible and causes distress.7. This systematic review has shown that patients with HF have an increased thirst that can be bothersome. Your doctor will also check for the presence of risk factors, such as high blood pressure, coronary artery disease or diabetes.Using a stethoscope, your doctor can listen to your lungs for signs of congestion. Clinical Journal of the American Society of Nephrology. Changes in Thirst Intensity During Optimization of Heart Failure Medical Therapy by Nurses at the Outpatient Clinic. Diabetes can make you feel hungry, tired, or thirsty; you may urinate more than normal and have blurry vision. Journal of Cardiovascular Pharmacology and Therapeutics. (i) How is thirst measured and described in patients with HF? Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. ice‐cubes). If your heart is weakened by heart failure, your kidneys may not get enough blood to work as well as they should. Heart failure does not mean your heart has stopped working. However, thirst should be considered a problem if patients are not allowed to respond to the thirst signal in a natural way (e.g. Allida, Sabine M.a; Hayward, Christopher S.b,c; Newton, Phillip J.d, aImproving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, cCardiology Department, St Vincent's Hospital, dNursing Research Centre, Western Sydney Local Health District and Western Sydney University, Sydney, Australia, Correspondence to Phillip J. Newton, Nursing Research Centre, Western Sydney Local Health District and Western Sydney University, Locked Bag 1797 Penrith, NSW 2751, Australia. accurately . [email protected]. Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Moreover, one of the following two criteria had to be fulfilled: (i) either thirst was a primary or secondary outcome; or else (ii) a statement regarding thirst was given by the HF patients in the Results section. The intervention group rated their mean thirst at baseline to 54 mm [standard deviation (SD) 15] and the control group rated it at 50 mm (SD 19) (Figure 3).19, Distress refers to what degree the patient is bothered by thirst. If drinking other fluids e.g. International Journal of Nursing Practice. Developed in collaboration with the Heart Failure Association (HFA) of the ESC, Impact of symptom prevalence and symptom burden on quality of life in patients with chronic heart failure, Predictors for health‐related quality of life in persons 65 years or older with chronic heart failure, Symptom distress and quality of life in patients with advanced congestive heart failure, Symptoms experienced in the last six months of life in patients with end‐stage heart failure, Thirst, drinking behaviour and involuntary dehydration, Collaborative development of middle‐range nursing theories: toward a theory of unpleasant symptoms, Advancing the science of symptom management, Thirst and hydration: physiology and consequences of dysfunction, Guyton and Hall Textbook of Medical Physiology, A middle‐range theory of self‐care of chronic illness, Role of self‐care in the patient with heart failure, Compliance in heart failure patients: the importance of knowledge and beliefs, Fluid overload and other mechanisms beyond fluid accumulation, Joanna Briggs Institute Reviewerś Manual: 2011 Edition, Liberal versus restricted fluid prescription in stabilised patients with chronic heart failure: result of randomised cross‐over study of the effects on health‐related quality of life, physical capacity, thirst and morbidity, Description of self‐reported fluid intake and its effects on body weight, symptoms, quality of life and physical capacity in patients with stable chronic heart failure, Effects of oral tolvaptan in patients hospitalised for worsening heart failure: the EVEREST outcome trial, A pilot study of salt and water restriction in patients with chronic heart failure, Thirst and QOL in persons with heart failure, Thirst in the elderly with and without heart failure, Living with severe chronic heart failure in palliative advanced home care, Keeping the maintenance of daily life in spite of chronic heart failure. In contrast to dyspnoea and fatigue, which are generally considered to be bothersome symptoms, thirst has been regarded as a normal physiological signal that might not be possible to treat effectively. For more information, please refer to our Privacy Policy. The mean age ranged from 44 to about mean 80 years, and the mean ejection fraction ranged from 23% to 45%. Data is temporarily unavailable. These search terms had to be identified anywhere in the text in the articles. Only chewing of gum has been tested with regards to alleviating thirst in renal failure patients, but with negative or ambiguous results.48,49. In most studies, the main results reflect a poor description of several dimensions of thirst. Although patients with heart failure (HF) may suffer from severe thirst, this has received little attention in scientific studies. Tel: +61 2 9851 6057, mobile: +61 411 057 056; e-mail: [email protected]. Heart failure means that the heart is unable to pump blood around the body properly. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failureAuswirkungen einer begrenzten Flüssigkeitsaufnahme auf die klinischen und Laborwertergebnisse bei Patienten mit Herzversagen. Log in to view full text. Both qualitative and quantitative studies were considered in order to capture various aspects of thirst. The stethoscope also picks up abnormal heart sounds that may suggest heart failure. may email you for journal alerts and information, but is committed To diagnose heart failure, your doctor will take a careful medical history, review your symptoms and perform a physical examination. A systematic literature review was conducted to identify and analyse data on thirst in HF. You may search for similar articles that contain these same keywords or you may If you’re getting swollen ankles, it’s worth making an appointment with your GP. The item(s) has been successfully added to ", This article has been saved into your User Account, in the Favorites area, under the new folder. Thirst and factors associated with frequent thirst in patients with heart failure in Spain. 1 cup cooked pasta or rice 100mL make you thirsty. You may be trying to access this site from a secured browser on the server. This website uses cookies. (iv) What interventions are described to alleviate thirst in HF patients? Congestive heart failure happens when the heart is not able to pump enough blood to meet the demands of the body. Medicines for Heart Failure There are many medicines used to help treat heart failure. It may take a bit longer, but breaking jobs down into smaller tasks can help - and it means that you’re still able to do the things you want to do. The consequences of thirst in HF were related to compliance, preoccupation with thirst, and a negative impact on quality of life. Standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Qualitative Assessment and Review Instrument (JBI‐QARI) and Meta Analysis of Statistics Assessment and Review Instrument (JBI‐MAStARI) were used, respectively.15. The total number of studied patients was 4375. Thirst in chronic heart failure: a review. In addition, therapy and lifestyle may influence the various paths of thirst mechanisms. Non‐pharmacological treatment is fundamental for maintaining physiological stability and QoL.10 Fluid restriction is a commonly used self‐care treatment1 and is, not surprisingly, associated with bothersome thirst.16,17,22–24 Restriction of fluid intake is based on logical reasoning but still remains poorly evaluated.35 Recent studies even question the value of fluid restriction.16,17 It seems that fluid restriction is associated with thirst16,17,22–24 and becomes less troublesome when HF patients are allowed to drink more fluid.16,17. Optimal evaluation of symptoms should include intensity, frequency, and distress.7,8 Thirst intensity was most often self‐assessed using the VAS score. Being thirsty from time to time is normal. Heart failure can make it hard to breathe when you walk up a flight of stairs. One paper presented thirst as a primary outcome21 and five papers as a secondary outcome.16–20 In three articles, thirst was presented as patient statements during interviews dealing with maintenance of daily life in HF, motivations for compliance, and the meaning of living with severe chronic HF.22–24 One study examined patients with worsening HF.21 One qualitative study included only patients with stable but severe HF,22 while seven articles consisted of patients in a stable phase of HF.16–20,23,24. A Randomised Controlled Trial of Chewing Gum to Relieve Thirst in Chronic Heart Failure (RELIEVE-CHF). It’s not unusual to crave a cold glass of water on a hot summer day or after you’ve eaten something particularly spicy. Registered users can save articles, searches, and manage email alerts. Feature Editor: Paul C. Rousseau Receptors sensing these changes stimulate the thirst centre in the brain. Self‐care is fundamental for maintaining QoL in HF,11,12 but self‐care monitoring activities may in fact increase thirst.13 HF patients are commonly advised to limit their fluid intake,1 which is based on the logical reasoning that excessive fluid intake overloads the heart.14 Another common self‐care practice in HF is to increase the dose of diuretics when fluid overload is detected.1 The limited knowledge about thirst in HF makes it unlikely that patients receive appropriate advice and help from caregivers. Severe CHF. If you do not receive an email within 10 minutes, your email address may not be registered, Your message has been successfully sent to your colleague. Of 174 screened citations, nine articles were included, in which a total of 4375 HF patients had been studied. A high serum sodium concentration raises the serum osmolality which, in turn, stimulates the osmoreceptors and gives rise to thirst.10 In patients with stable HF, the serum sodium concentration has averaged 140 and 138 mmol/L regardless of ingested fluid volume or intake of salt.16,17,19 In these studies, the relationship between thirst and serum sodium was not reported. However, patients with HF are believed to be fluid overloaded when they do not receive therapy.36 In contrast, patients with HF undergoing standard drug therapy have a significantly lower intravascular volume than expected.37 As dehydration lowers the blood volume, which increases angiotensin II secretion, a state of hypovolaemia might contribute to the increased thirst in HF. Acute myocardial infarction in rats: Role of autophagy criterion was that HF had been diagnosed to. 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