A Case of Dexmedetomidine (Precedex)-Induced Diabetes Insipidus in the Medical Intensive Care Unit

Charran, Ordessia; Lee, Y.I.

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6634

Cited by 5 publications

(10 citation statements)

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“…To our knowledge, only one other case in a medical intensive care unit has been published in abstract form [3]. Polyuria associated with dexmedetomidine, a highly selective α2-adrenoceptor agonist that works on the locus coeruleus, has been reported in case report form, almost exclusively in perioperative conditions [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Morelli et al demonstrated that dexmedetomidine is associated with decreased norepinephrine requirements in septic shock patients as compared with propofol [ 1 ]. While hypotension and bradycardia [ 2 ] are known side effects, the occurrence of central diabetes insipidus (DI) due to dexmedetomidine is a rare phenomenon and not well documented in literature [ 3 , 4 ]. Rapid onset of dehydration due to fluid loss and electrolyte imbalance may further worsen hypotension and cause complications in already critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

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Dexmedetomidine Induced Polyuria in the Intensive Care Unit

Uddin

Sebastian

Usama

et al. 2021

Case Reports in Critical Care

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Dexmedetomidine is an α2-adrenergic used as an adjunct therapy for sedation in the intensive care unit. While it is known to cause polyuria exclusively in perioperative conditions, not many cases are known in the intensive care unit, thus making the diagnosis challenging. We present the case of a 61-year-old male who had developed polyuria secondary to central diabetes insipidus after receiving dexmedetomidine intravenous infusion in the medical ICU. Increased awareness of this uncommon side effect of dexmedetomidine will help clinicians recognize and address it early.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Induced Polyuria in the Intensive Care Unit

Uddin

Sebastian

Usama

et al. 2021

Case Reports in Critical Care

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“…[ 2 ] There are report of transient CDI developing during nasal sinus surgery and during dexmedetomidine infusion, from unknown etiology. [ 5 6 ]…”

Section: Discussionmentioning

confidence: 99%

Intraoperative central diabetes insipidus in a postpartum patient during decompression of base of brain lesion: Missing out the diagnosis of Sheehan's syndrome?

et al. 2021

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A 35-year-old female presented with headache in the third week postpartum period following uneventful cesarean delivery. She had left sided ptosis, pain, and numbness over left face since third trimester. Post-delivery magnetic resonance imaging revealed invading left sphenoid sinus meningioma. She was planned for combined endonasal and pterional craniotomy. Her preoperative investigations including sodium, glucose, and liver functions were normal. Intraoperatively during endonasal phase a high urine output (UO) with rising sodium were noticed which continued with worsening sodium (156 mEq/L after 3 h). Desmopressin 1 mcg IV administered which normalized UO for the rest of surgical duration with trends of declining sodium (149 mEq/L at the end of procedure). Her postoperative MRI was normal however desmopressin could not be discontinued because of increasing sodium and UO without it. She was discharged on oral desmopressin, hydrocortisone and levothyroxine. On her follow-up 3.5 months later she had normal sodium and normal UO.

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“…Hypotension and bradycardia are the most common adverse effects associated with dexmedetomidine; however, there have been rare reports of diabetes insipidus (DI) associated with this agent. 2-9 We report a case of DI following dexmedetomidine use in a patient who presented to the surgical ICU with severe burn injury.…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…12 Although the mechanism of alpha-2 agonists induced DI is not fully understood, studies have shown that dexmedetomidine may impact vasopressin secretion and responsiveness and may be linked to be the blockade of AVP release caused by the alpha-2 agonism, causing excessive free water excretion. 4,14,15 However, previous animal studies have displayed alpha-2 agonists lead to AVP resistance at the renal level. [16][17][18][19] Dexmedetomidine may be responsible for both a central and nephrogenic cause of free water excretion.…”

Section: Case Summarymentioning

confidence: 99%

Probable Dexmedetomidine Induced Diabetes Insipidus: A Case Review

Vani

Stackpole

Kovacevic

2021

Journal of Pharmacy Practice

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What is known and objective: Despite increased use of dexmedetomidine as a light sedative in the ICU setting, diabetes insipidus (DI) secondary to a dexmedetomidine infusion has rarely been reported. Case summary: We present a 32-year-old male admitted to the surgical intensive care unit (ICU) with 50% total body surface area burn. A short time following initiation (0.2 mcg/kg/hr) and up-titration (0.8 mcg/kg/hr) of dexmedetomidine continuous infusion, the patient developed DI, eventually exceeding 3 L of urine within a 6-hour timeframe. Excessive polyuria also led to significant electrolyte shifts (serum sodium 156 mmol/L and serum potassium < 1.8 mmol/L), resulting in Torsade’s de Pointes. What is new and conclusion: Our case discusses diabetes insipidus leading to severe electrolyte abnormalities secondary to dexmedetomidine.

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A Case of Dexmedetomidine (Precedex)-Induced Diabetes Insipidus in the Medical Intensive Care Unit

Cited by 5 publications

References 0 publications

Dexmedetomidine Induced Polyuria in the Intensive Care Unit

Dexmedetomidine Induced Polyuria in the Intensive Care Unit

Intraoperative central diabetes insipidus in a postpartum patient during decompression of base of brain lesion: Missing out the diagnosis of Sheehan's syndrome?

Probable Dexmedetomidine Induced Diabetes Insipidus: A Case Review

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