Probable Dexmedetomidine Induced Diabetes Insipidus: A Case Review

Abstract

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.

Dexmedetomidine-induced diabetes insipidus during coronary artery bypass graft surgery

“…Several studies have noted anecdotally that surgeries involving the central nervous system are more likely to result in dexmedetomidine-induced polyuria, likely due to the fact that AVP is released by the posterior pituitary gland [ 10 – 12 ]. However, polyuria has also been observed in a wide variety of patients receiving dexmedetomidine including, patients in their sixties undergoing orthopaedic surgery, otolaryngologic surgery, and a 32-year-old male in the ICU for burns [ 12 – 14 ]. A literature review found that the renal effects of dexmedetomidine on patients undergoing CABG surgery have been examined with an experimental trial.…”