Nephrogenic Diabetes Insipidus During Prolonged Sevoflurane Sedation in the ICU: a Retrospective Analysis

Study Overview
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Brief Summary
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The investigators aim to retrospectively explore the electronic medical records of all patients who were admitted to the Intensive Care Unit (ICU) of the UZ Brussels in the last 10 years (March 1st 2011- March 1st 2021) and who received prolonged sedation (>24h) with sevoflurane.

Official Title
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Incidence of Nephrogenic Diabetes Insipidus During Prolonged Sevoflurane Sedation in the Intensive Care Unit: a Retrospective Analysis

Conditions
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Nephrogenic Diabetes Insipidus

Intervention / Treatment
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* Drug: Sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Sevoflurane administration >24h 18 years and older Exclusion Criteria: < 18 years old Pre-existing diabetes insipidus Use of drugs at risk for diabetes insipidus (including lithium, cisplatin) Hypercalcemia (persistently >2.75 mmol/L) Pituitary or acute brain surgery Patients requiring continuous renal replacement therapy Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sevoflurane group<br>Patients that received sevoflurane while in ICU care. | Drug: Sevoflurane<br>* Sevoflurane administration to sedate the patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nephrogenic Diabetes Insipidus prevalence | How many patients under sevoflurane sedation ultimately develop NDI? NDI confirmed by demonstrating the absence of a urine concentrating response to exogenous Arginine Vasopressine. | up to 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients that develop risk factors of NDI | Number of patients that develop risk factors (electrolyte disorder, urinary obstruction) for NDI. | up to 8 weeks | 
| Amount of time patient was placed under sevoflurane sedation. | How long are they under sevoflurane sedation. | up to 8 weeks | 
| Number of patients with electrolyte abnormalities as assessed by lab results. | Lab results of hematology and chemistry labs show an electrolyte imbalance. | during hospitalization, up to 8 weeks. | 
| Number of patients with excessive urine output | Amount of urine output: >40 ml/kg/24h | during hospitalization, up to 8 weeks. | 
| Number of patients with an abnormal physical examination. | Typical physical symptoms of (N)DI: tired, lethargic, tachycardia, tachypnea, hypotension and dry mucous membranes. | during hospitalization, up to 8 weeks. | 
| Number of patients with urine with an abnormal osmolality | Lab testing of urine: osmolality < 300 mosm/kg | during hospitalization, up to 8 weeks. | 
| Number of patients that show an abnormal amount of fluid intake | >2.5l/day | during hospitalization, up to 8 weeks. | 
| Number of patients that have an abnormal abdominal echo of the bladder. | Echo shows an enlarged bladder. | during hospitalization, up to 8 weeks. | 
| Number of symptoms of NDI | Number of symptoms of NDI do these patients show? | up to 8 weeks | 
| Timing of symptoms of NDI | After how much time do these patients show symptoms of NDI? | up to 8 weeks |