We searched PubMed, Embase, Scopus, Google Scholar, and Web of Science. Search terms included \"polyuria,\" \"diabetes insipidus,\" \"hypnotics and sedatives,\" \"sedation,\" as well as individual medications. Case reports or series involving DI or polyuria related to sedation in the ICU were identified.
We identified 21 cases of diabetes insipidus or polyuria in the ICU attributed to a sedative. Dexmedetomidine was implicated in 42.9% of cases, followed by sevoflurane (33.3%) and ketamine (23.8%). Sevoflurane was implicated in all 7 cases in which it was used (100%; 95% CI 59.0%, 100.0%), dexmedetomidine in 9 of 11 cases (81.8%; 95% CI 48.2, 97.7), and ketamine in 5 of 9 cases (55.6%; 95% CI 21.2%, 86.3%).
Awareness of the potential for sedatives to cause DI may lead to greater identification with swifter medication discontinuation and subsequent resolution of DI.
方法:我们搜索了PubMed,Embase,Scopus,谷歌学者,和WebofScience。搜索词包括“多尿症,\"\"尿崩症,\"\"催眠药和镇静剂,\"\"镇静剂,“以及个人药物。确定了涉及DI或与ICU镇静相关的多尿的病例报告或系列。
结果:我们在ICU中确定了21例因镇静剂引起的尿崩症或多尿。在42.9%的病例中涉及右美托咪定,其次是七氟醚(33.3%)和氯胺酮(23.8%)。七氟醚在所有7例使用中都有牵连(100%;95%CI59.0%,100.0%),右美托咪定在11例中的9例(81.8%;95%CI48.2,97.7),9例中有5例和氯胺酮(55.6%;95%CI21.2%,86.3%)。
结论:对镇静剂引起DI的潜力的认识可能会导致更好的识别,更快的药物停药和随后的DI解决。