与重症监护病房镇静相关的尿崩症：文献复习。
Diabetes insipidus related to sedation in the intensive care unit: A review of the literature.
机构信息
Anesthesiology, Department of Anesthesiology and Perioperative Medicine, 5777 E Mayo Blvd, Phoenix, AZ 85054, United States of America.
Anesthesiology, Department of Anesthesiology and Perioperative Medicine, 5777 E Mayo Blvd, Phoenix, AZ 85054, United States of America.
出版信息
J Crit Care. 2023 Jun;75:154233. doi: 10.1016/j.jcrc.2022.154233. Epub 2023 Feb 2.
PURPOSE
To identify cases of diabetes insipidus (DI) related to sedation in the ICU to determine which medications pose the greatest risk and understand patterns of presentation.
MATERIALS AND METHODS
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.
RESULTS
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%).
CONCLUSIONS
Awareness of the potential for sedatives to cause DI may lead to greater identification with swifter medication discontinuation and subsequent resolution of DI.
目的
确定 ICU 镇静相关的尿崩症（DI）病例，以确定哪些药物的风险最大，并了解其表现模式。
材料和方法
我们检索了 PubMed、Embase、Scopus、Google Scholar 和 Web of Science。检索词包括“多尿”、“尿崩症”、“催眠镇静药和镇静剂”、“镇静”以及个别药物。确定了与 ICU 镇静相关的 DI 或多尿的病例报告或系列。
结果
我们确定了 21 例 ICU 中与镇静相关的尿崩症或多尿，其中涉及镇静剂。右美托咪定在 42.9%的病例中被牵连，其次是七氟醚（33.3%）和氯胺酮（23.8%）。七氟醚在其使用的所有 7 例中都被牵连（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%），氯胺酮在 9 例中的 5 例（55.6%；95%CI21.2%，86.3%）。
结论
意识到镇静剂可能导致 DI，可能会导致更频繁地识别，更快地停止用药，并随后解决 DI。
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