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Figure legends
314
Figure 1．Protocol of our observational study
315
Thirst NRS, oral moisture, and modified ROAG were evaluated before and after the oral care.
316
The arrows show the timing of assessments.
317
NRS = numerical rating scale, ROAG = revised oral assessment guide
318
319
Figure 2. Thirst numerical rating scale before and after the oral care
320
We showed the thirst numerical rating scale after the oral care. Before oral care, numerical rating
321
scale was 6 (5–8), and it significantly decreased 0 and 1 hour after the oral care. Data were
322
presented as median (interquartile range), and compared using the Wilcoxon signed-rank test.
323
* Significant at p = 0.04, ** Significant at p < 0.01
324
NRS = numerical rating scale
325
326
Figure 3. Oral moisture before and after the oral care
327
We showed oral moisture after the oral care. Before oral care, oral moisture was 28.9% (27.2%–
328
30.3%), and it did not change significantly after the oral care. During the study period, the
329
median oral moisture was maintained in a normal level ≥ 27.0%. Data were presented as median
330
(interquartile range), and compared using the Wilcoxon signed-rank test.
331
332
Figure 4. Modified Revised Oral Assessment Guide before and after the oral care
333
We showed modified ROAG before and after the oral care. Modified ROAG included only
334
tongue, mucous membrane, and saliva. Before oral care, the modified ROAG was limited to 4
335
(3–5),1 (1–2), 1 (1–1), and 2 (1–2) at sum, tongue, mucous membrane, and saliva. These low
336
scores further decreased immediately after oral care and at the last evaluation.
337
Data were presented as median, and the changes were compared using the Wilcoxon signed-rank
338
test.
14
15
339
ROAG = revised oral assessment guide
340
341
Figure 5. The correlation among numerical rating scale, oral moisture, and modified ROAG.
342
There was no significant correlation between numerical rating scale and oral moisture or
343
modified ROAG, while there was a negative correlation between modified ROAG and oral
344
moisture.
345
ROAG = revised oral assessment guide
15
Final assessment was conducted when patients
required oral care.
Assess
Before
oral care
Oral care
Assess
Assess
Assess
Assess
Assess
0 hour
1 hour
2 hour
3 hour
4 hour
Thirst NRS
Oral moisture
Modified
ROAG
Evaluation at the final assessment
No. of patients
86
**
86
70
29
10
No. of patients
86
86
70
29
10
No. of patients
86
** ** ** **
** * * **
86
86
40
30
30
20
ρ = −0.01
p = 0.96
n = 86
10
ρ = 0.09
p = 0.42
n = 86
Numerical rating scale
10
Numerical rating scale
10
Oral moisture (%)
Modified ROAG
Oral moisture (%)
40
20
ρ = −0.22
p = 0.04
n = 86
10
Modified ROAG
10
Table 1 Patient characteristics
Variables
Overall (n = 86)
Age, years
70 (62–77)
Sex (Men), n (%)
54 (63)
APACHE II score
20 (14–29)
Length of ICU stay, days
4 (2–9)
Examination day after ICU admission
2 (2–5)
ICU admission reasons, n (%)
Cardiovascular
27 (31)
Digestive
23 (27)
Respiratory
12 (14)
Sepsis
7 (11)
Cerebrovascular
5 (6)
Other
12 (14)
Postoperative admission, n (%)
51 (61)
Mechanically ventilation, n (%)
18 (21)
High flow nasal cannula, n (%)
13 (15)
Permitted oral intake state, n (%)
24 (28)
Plasma osmolality, mosmol/kg
297 (290–305)
APACHE II = Acute Physiology and Chronic Health
Evaluation II, ICU = intensive care unit
Data were presented as median (interquartile range) unless
otherwise indicated.
Table 2 Risk factor of thirst perception
Mild
Moderate
Severe
NRS = 0–3
NRS = 4–6
NRS = 7–10
(n = 9)
(n = 37)
(n = 40)
value
5 (56)
21 (57)
28 (70)
0.43
Age, years
61 (60–76)
73 (64–80)
69 (56–75)
0.12
APACHE II score
21 (16–26)
20 (16–28)
18 (12–32)
0.85
291 (283–295)
296 (290–304)
300 (290–310)
0.12
15 (11–23)
21 (15–40)
22 (13–39)
0.19
138 (136–140)
139 (137–143)
140 (138–144)
0.10
Permitted oral intake, n (%)
3 (33)
14 (38)
7 (18)
0.15
Mechanical ventilation, n (%)
1 (11)
6 (16)
11 (28)
High flow nasal cannula, n (%)
3 (33)
7 (19)
3 (8)
Nasal cannula or mask, n (%)
4 (44)
13 (35)
18 (45)
Variables
Sex (Male), n (%)
Plasma osmolality, mosmol/kg
Blood urea nitrogen, mg/dL
Sodium, mmol/L
APACHE II = Acute Physiology and Chronic Health Evaluation II
Data were presented as median, and the data were compared using the Kruskal-Wallis test.
0.29
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