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Avoiding kidney damage in ICU sedation with sevoflurane: use isoflurane instead
1Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
British Journal of Anaesthesia
|March 25, 2022
Summary
Sevoflurane sedation in intensive care units (ICUs) may cause nephrogenic diabetes insipidus. Clinicians should discontinue sevoflurane for ICU sedation, favoring isoflurane, except in clinical trials.
Area of Science:
- Anesthesiology
- Nephrology
- Critical Care Medicine
Background:
- Intensive care unit (ICU) sedation is crucial for patient management.
- Sevoflurane has been a commonly used anesthetic agent for ICU sedation.
Discussion:
- Sevoflurane use in ICUs is linked to nephrogenic diabetes insipidus.
- Isoflurane is now licensed for ICU sedation in Europe and has Investigational New Drug status in the USA.
- This evidence suggests a shift in anesthetic practices for ICU sedation.
Key Insights:
- Association between sevoflurane and nephrogenic diabetes insipidus in ICU patients.
- Availability and regulatory status of isoflurane for ICU sedation.
- Clinical recommendation to cease sevoflurane use outside of trials.
Outlook:
- Potential for reduced incidence of nephrogenic diabetes insipidus with alternative agents.
- Further research may explore long-term outcomes of isoflurane in ICU settings.
- Implications for anesthetic protocols and patient safety in critical care.
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