Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 26 , ISSUE 7 ( July, 2022 ) > List of Articles

SYSTEMATIC REVIEW

Diabetes Insipidus after Vasopressin Withdrawal: A Scoping Review

Raquel S Pérsico, Marina V Viana, Luciana V Viana

Keywords : Arginine vasopressin, Critical care, Diabetes insipidus, Hypernatremia, Intensive care units

Citation Information : Pérsico RS, Viana MV, Viana LV. Diabetes Insipidus after Vasopressin Withdrawal: A Scoping Review. Indian J Crit Care Med 2022; 26 (7):846-852.

DOI: 10.5005/jp-journals-10071-24244

License: CC BY-NC 4.0

Published Online: 15-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Objectives: The objective of this study is to synthesize the current literature about the relationship between the occurrence of diabetes insipidus (DI), its diagnosis criteria, and management after withdrawal of vasopressin (VP) in critically ill. Data sources: This scoping review followed the recommendations of Preferred Reporting Items for Systematic Review and Meta-Analyses for Scoping Review (PRISMA-ScR). The search literature was conducted in MEDLINE and EMBASE databases, until March 2022. A manual search was also conducted in order to include articles that were not identified in the initial search performed in the databases. Study selection and data extraction: The selection of studies and extraction of data were carried out in a paired and independent manner. There was no restriction regarding the language of publication of the included manuscripts. Data synthesis: The analysis included 17 studies (16 case reports and one retrospective cohort). All studies used VP, with a median time of drug infusion of 48 hours (IQR: 16–72) and DI incidence of 1.53%. The diagnosis of DI was based on diuresis output and concomitant hypernatremia or changes in serum sodium concentration, with median time to symptoms onset after discontinuation of VP of 5 hours (IQR: 3–10). The treatment of DI consisted mainly of fluid management and the use of desmopressin. Conclusions: DI after VP withdrawal was present in 51 patients described in 17 studies, but diagnosis and management varied among each report. Using the available data, we propose a diagnosis suggestion and a flowchart for managing patients with DI after withdrawal of VP in the Intensive Care Unit. Multicentric collaborative research is urgently needed to obtain more quality data on this topic.


HTML PDF Share
  1. Ukor IF, Walley KR. Vasopressin in vasodilatory shock. Crit Care Clin 2019;35(2):247–261. DOI: 10.1016/j.ccc.2018.11.004.
  2. Bankir L, Bichet DG, Morgenthaler NG. Vasopressin: physiology, assessment and osmosensation. J Intern Med 2017;282(4):284–297. DOI: 10.1111/joim.12645.
  3. Goldsmith SR. Vasopressin as vasopressor. Am J Med 1987;82(6): 1213–1219. DOI: 10.1016/0002-9343(87)90228-2.
  4. Christ-Crain M, Bichet DG, Fenske WK, Goldman MB, Ritting S, Verbalis JG, et al. Diabetes insipidus. Nat Rev Dis Primers 2019;5(1): 1–20. DOI: 10.1038/s41572-019-0103-2.
  5. Harrois A, Anstey JR. Diabetes insipidus and syndrome of inappropriate antidiuretic hormone in critically ill patients. Crit Care Clin 2019;35(2):187–200. DOI: 10.1016/j.ccc.2018.11.001.
  6. Vries F De, Lobatto DJ, Verstegen MJT, Furth WR Van, Pereira AM, Biermasz NR. Postoperative diabetes insipidus: how to define and grade this complication? Pituitary 2021;24(2):284–291. DOI: 10.1007/s11102-020-01083-7.
  7. Ferenchick H, Cemalovic N, Ferguson N, Dicpinigaitis PV. Diabetes insipidus after discontinuation of vasopressin infusion for treatment of shock. Crit Care Med 2019;47(12):e1008–e1013. DOI: 10.1097/CCM.0000000000004045.
  8. Bohl MA, Forseth J, Nakaji P. Transient diabetes insipidus after discontinuation of vasopressin in neurological ICU patients: Case series and literature review. World Neurosurg 2017;97:479–488. DOI: 10.1016/j.wneu.2016.09.122.
  9. Vail EA, Gershengorn HB, Hua M, Walkey AJ, Wunsch H. Epidemiology of vasopressin use for adults with septic shock. Ann Am Thorac Soc 2016;13(10):1760–1767. DOI: 10.1513/AnnalsATS.201604-259OC.
  10. Russell JA. Bench-to-bedside review: vasopressin in the management of septic shock. Crit Care 2011;15(4):226. DOI: 10.1186/cc8224.
  11. Russell JA, Walley KR, Gordon AC, Cooper DJ, Hébert PC, Singer J, et al. Interaction of vasopressin infusion, corticosteroid treatment, and mortality of septic shock. Crit Care Med 2009;37(3):811–818. DOI: 10.1097/CCM.0b013e3181961ace.
  12. Bhaskar P, John J, Sallehuddin AB. Polyuria after cessation of vasopressin in a child after cardiac surgery. J Cardiothorac Vasc Anesth 2014;28(3):e24–e25. DOI: 10.1053/j.jvca.2014.01.014.
  13. Shah S. Curiously rare case of hyponatremia with continuous vasopressin infusion for shock. Crit Care Med 2011;39(12):251. DOI: 10.1097/01.ccm.0000408627.24229.88.
  14. Ramers C, Govert JA, Clay AS. Transient acquired diabetes insipidus after vasopressin therapy for hypotension: a case report. Chest 2005;128(4):454S. DOI: 10.1378/chest.128.4_MeetingAbstracts.454S.
  15. Morkos M, Fam M, Goel M, Hart P, Kazlauskaite R. Protracted acute hypervolemic hypernatremia unmasked after vasopressin therapy: case report, literature review, and proposed algorithmic approach. AACE Clin Case Rep 2019;5(2):95–98. DOI: 10.4158/ACCR-2018-0363.
  16. Hayes-bradley C, Nagaratnam V. Diabetes insipidus following the withdrawal of a vasopressin infusion. J Intensive Care Soc 2011;12(4):343–344. DOI: 10.1177/175114371101200426.
  17. Carman N, Kay C, Petersen A, Kravchenko M, Tate J. Transient central diabetes insipidus after discontinuation of vasopressin. Case Rep Endocrinol 2019;1–4. DOI: 10.1155/2019/4189525.
  18. Sundar K, Biesboer A. Transient diabetes insipidus upon discontinuation of vasopressin infusion. Crit Care Med 2016;44(12):495. DOI: 10.1097/01.ccm.0000510351.90007.6f.
  19. Rana H, Ferguson N, Dicpinigaitis PV. Diabetes insipidus after discontinuation of vasopressin infusion for septic shock. J Clin Pharm Ther 2018;43(2):287–290. DOI: 10.1111/jcpt.12627.
  20. Peskey CS, Mauermann WJ, Meyer SR, Abel MD. Vasopressin withdrawal associated with massive polyuria. J Thorac Cardiovasc Surg 2009;138(2):491–492. DOI: 10.1016/j.jtcvs.2008.06.032.
  21. Shiber JR, Johnson D. Iatrogenic central diabetes insipidus induced by vasopressin withdrawal. Open J Clin Med Case Rep 2015;1(7):1–5.
  22. Cobb C, Osakwe IN. Acute transient central diabetes insipidus: a rare case of DI secondary to vasopressin withdrawal. J Endocrine Soc 2021;5(1):A571. DOI: 10.1210/jendso/bvab048.1164.
  23. Kim K, Mody N, Chernoff A, Gupta S, Lekprasert P, Patarroyo-Aponte G. Transient diabetes insipidus after vasopressin use in a patient with Wernicke's encephalopathy. J Clin Transl Endocrinol Case Rep 2020;17:100067. DOI: 10.1016/j.jecr.2020.100067.
  24. Kristeller JL, Sterns RH. Transient diabetes insipidus after discontinuation of therapeutic vasopressin. Pharmacotherapy 2004;24(4):541–545. DOI: 10.1592/phco.24.5.541.33348.
  25. Katayama A, Ono K, Hidaka H, Koyama Y, Ishii K. Decrease of vasopressin concentrations with septic shock induce diabetes insipidus. Crit Care Med 2014;42(12):pA1660. DOI: 10.1097/01.ccm.0000458753.34304.18.
  26. Cristiano EA, Harris A, Grdinovac K. Transient central diabetes insipidus occurring after vasopressin infusion. AACE Clin Case Rep 2022;8(1):8–10. DOI: 10.1016/j.aace.2021.06.004.
  27. Russell JA. Vasopressor therapy in critically ill patients with shock. Intensive Care Med 2019;45(11):1503–1517. DOI: 10.1007/s00134-019-05801-z.
  28. Russell JA, Walley KR, Singer J, Gordon AC, Hébert PC, Cooper J, et al. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 2008;358(9):877–887. DOI: 10.1056/NEJMoa067373.
  29. Nagendran M, Russell JA, Walley KR, Brett SJ, Perkins GD, Hajjar L, et al. Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials. Intensive Care Med 2019;45(6):844–855. DOI: 10.1007/s00134-019-05620-2.
  30. Nedel WL, Rech TH, Ribeiro RA, Pellegrini JAS, Moraes RB. Renal outcomes of vasopressin and its analogs in distributive shock: a systematic review and meta-analysis of randomized trials. Crit Care Med 2019;47(1):E44–E51. DOI: 10.1097/CCM.0000000000003471.
  31. Nasa P, Varma G, Kulkarni A, Chaudhary S, Sagar P. Central diabetes insipidus in an off-pump coronary artery bypass grafting surgery. IJCCM 2019;23(11):523–525. DOI: 10.5005/jp-journals-10071- 23278.
  32. Uchino S, Kellum J, Bellomo R, Doig G, Morimatsu H, Morgera S, et al. Acute renal failure in critically ill patients. JAMA 2005;294(7):813–818. DOI: 10.1001/jama.294.7.813.
  33. Hu B, Han Q, Mengke N, He K, Zhang Y, Nie Z, et al. Prognostic value of ICU-acquired hypernatremia in patients with neurological dysfunction. Medicine (Baltimore) 2016;95(35):e3840. DOI: 10.1097/MD.0000000000003840.
  34. Douglas IS. Comments about diabetes insipidus after discontinuation of vasopressin infusion for treatment of shock. Crit Care Med 2020;48(3):256–257. DOI: 10.1097/CCM.0000000000004119.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.