Abstract

Volatile anesthetic agents, such as sevoflurane, are increasingly used for long-term sedation in intensive care units worldwide, with improved clinical outcomes reported in recent studies due to favorable pharmacological properties. Despite possible renal toxicity related to the production of plasma inorganic fluoride and concerns related to reversible impairment of renal concentrating abilities, renal injury associated with sevoflurane sedation has rarely been reported in the intensive care unit setting. We hereby report 3 cases of nephrogenic diabetes insipidus associated with prolonged sevoflurane sedation using the AnaConDa device and review the possible mechanisms of renal toxicity.