This observational study investigated the renal impact of prolonged sevoflurane sedation in Intensive Care Unit (ICU) patients, focusing specifically on the incidence of polyuria (excessive urine output, defined as > 3000 mL/d).

Study Summary and Key Findings

Objective: To examine the frequency and factors associated with polyuria in ICU patients receiving sevoflurane for sedation.

Patients and Method: Researchers analyzed 76 consecutive ICU patients who received sevoflurane sedation, excluding those already on renal replacement therapy. Sevoflurane was administered via an anesthetic conserving device for a median duration of 118 hours (about 5 days).

High Prevalence of Polyuria: 42% of patients (32 out of 76) developed polyuria during the first 7 days of sedation.

Prolonged Exposure is Key: Multivariate analysis showed that prolonged sevoflurane exposure (greater than one day) significantly increased the risk of developing polyuria (Odds Ratio = 1.26, P = .009). The risk grows with the duration of the sedation.

Clinical Indicators: Polyuria was associated with higher urine output, serum sodium level, and osmolarity.

Contrast with AKI: Interestingly, acute kidney injury (AKI) was negatively associated with polyuria, suggesting polyuria is a distinct complication.

Conclusion: Polyuria is a common complication of prolonged sevoflurane sedation. The findings underscore the critical need for clinicians to closely monitor urine output and serum sodium levels in patients receiving this type of long-term sedation.

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