Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression

During the recent COVID-19 pandemic, the rapidly progressive shortage of intravenous sedative drugs led numerous intensive care units to look for potential alternatives in patients requiring mechanical ventilation for severe acute respiratory distress syndrome (ARDS). Inhalational sedation using the...

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Main Authors: Camie Dupuis, Arnaud Robert, Ludovic Gerard, Johann Morelle, Pierre-François Laterre, Philippe Hantson
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2022/3312306
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author Camie Dupuis
Arnaud Robert
Ludovic Gerard
Johann Morelle
Pierre-François Laterre
Philippe Hantson
author_facet Camie Dupuis
Arnaud Robert
Ludovic Gerard
Johann Morelle
Pierre-François Laterre
Philippe Hantson
author_sort Camie Dupuis
collection DOAJ
description During the recent COVID-19 pandemic, the rapidly progressive shortage of intravenous sedative drugs led numerous intensive care units to look for potential alternatives in patients requiring mechanical ventilation for severe acute respiratory distress syndrome (ARDS). Inhalational sedation using the AnaConDa® device for sevoflurane administration is a possible option. In a 54-year-old COVID-19 patient with severe ARDS requiring extracorporeal membranous oxygenation (ECMO), sevoflurane on AnaConDa® device was administered for 8 days but was complicated by the development of nephrogenic diabetes insipidus (NDI). Other causes of NDI or central diabetes insipidus were reasonably excluded, as in other previously published cases of NDI in ICU patients receiving prolonged sevoflurane-based sedation. In addition, the postmortem examination suggested a lower expression of aquaporin-2 in renal tubules. This observation should prompt further investigations to elucidate the role of aquaporin-2 in sevoflurane-related NDI. Inhaled isoflurane sedation is a possible alternative.
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spelling doaj-art-76569bcf3e6a4473ac67e39d9fb06fac2025-08-20T02:07:16ZengWileyCase Reports in Anesthesiology2090-63902022-01-01202210.1155/2022/3312306Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal ExpressionCamie Dupuis0Arnaud Robert1Ludovic Gerard2Johann Morelle3Pierre-François Laterre4Philippe Hantson5Department of Intensive CareDepartment of Intensive CareDepartment of Intensive CareDivision of NephrologyDepartment of Intensive CareDepartment of Intensive CareDuring the recent COVID-19 pandemic, the rapidly progressive shortage of intravenous sedative drugs led numerous intensive care units to look for potential alternatives in patients requiring mechanical ventilation for severe acute respiratory distress syndrome (ARDS). Inhalational sedation using the AnaConDa® device for sevoflurane administration is a possible option. In a 54-year-old COVID-19 patient with severe ARDS requiring extracorporeal membranous oxygenation (ECMO), sevoflurane on AnaConDa® device was administered for 8 days but was complicated by the development of nephrogenic diabetes insipidus (NDI). Other causes of NDI or central diabetes insipidus were reasonably excluded, as in other previously published cases of NDI in ICU patients receiving prolonged sevoflurane-based sedation. In addition, the postmortem examination suggested a lower expression of aquaporin-2 in renal tubules. This observation should prompt further investigations to elucidate the role of aquaporin-2 in sevoflurane-related NDI. Inhaled isoflurane sedation is a possible alternative.http://dx.doi.org/10.1155/2022/3312306
spellingShingle Camie Dupuis
Arnaud Robert
Ludovic Gerard
Johann Morelle
Pierre-François Laterre
Philippe Hantson
Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression
Case Reports in Anesthesiology
title Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression
title_full Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression
title_fullStr Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression
title_full_unstemmed Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression
title_short Nephrogenic Diabetes Insipidus following an Off-Label Administration of Sevoflurane for Prolonged Sedation in a COVID-19 Patient and Possible Influence on Aquaporin-2 Renal Expression
title_sort nephrogenic diabetes insipidus following an off label administration of sevoflurane for prolonged sedation in a covid 19 patient and possible influence on aquaporin 2 renal expression
url http://dx.doi.org/10.1155/2022/3312306
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