{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:37:38Z","timestamp":1781649458888,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Dexmedetomidine, propofol, and sevoflurane are widely used anesthetic agents, but reports of water metabolism disturbances\u2014particularly drug\u2010induced diabetes insipidus (DI)\u2014associated with their use remain extremely rare. We report a case of a 51\u2010year\u2010old Chinese man who developed abrupt high\u2010volume polyuria (&gt;\u2009600\u2009mL\/h; 24\u2010h output of 8750\u2009mL), hypotonic urine (specific gravity 1.003; osmolality 175\u2009mOsm\/kg), progressive hypernatremia (peak 156\u2009mmol\/L), hemoconcentration, lactic acidosis, and hypotension following transurethral seminal vesiculoscopy performed under general anesthesia. The patient was initially suspected of having an anaphylactic reaction, but standard interventions were ineffective. After exclusion of other causes, a diagnosis of anesthetic\u2010associated DI with secondary hypovolemic shock was made. The patient responded to aggressive fluid and electrolyte replacement alongside norepinephrine support. Polyuria resolved within approximately 18\u2009h, serum sodium normalized, and the patient was discharged from the ICU on postoperative Day 3. This case emphasizes that persistent dilute polyuria with rising serum sodium after anesthesia should prompt early evaluation for DI. When such complications arise, timely diagnosis, targeted fluid management, and hormone replacement therapy when appropriate can be crucial for preventing potentially life\u2010threatening outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.72738","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T03:57:14Z","timestamp":1779076634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transient Postoperative Diabetes Insipidus With Hypovolemic Shock Temporally Associated With Dexmedetomidine, Propofol, and Sevoflurane: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6588-6898","authenticated-orcid":false,"given":"Yuan","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengwei","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shuguang Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.ecl.2020.05.012","article-title":"Diabetes Insipidus: An Update","volume":"49","author":"Refardt J.","year":"2020","journal-title":"Endocrinology and Metabolism Clinics of North America"},{"issue":"1","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1213\/ANE.0000000000005344","article-title":"Perioperative Diabetes Insipidus Caused by Anesthetic Medications: A Review of the Literature","volume":"134","author":"Van Decar L. M.","year":"2022","journal-title":"Anesthesia and Analgesia"},{"issue":"2","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s11102-020-01083-7","article-title":"Postoperative Diabetes Insipidus: How to Define and Grade This Complication?","volume":"24","author":"Vries F.","year":"2021","journal-title":"Pituitary"},{"issue":"1","key":"e_1_2_13_5_1","first-page":"E79","article-title":"Postobstructive Diuresis: Pay Close Attention to Urinary Retention","volume":"9","author":"Halbgewachs C.","year":"2015","journal-title":"Canadian Urological Association Journal = Journal de L'association Urologique du Canada"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1093\/bja\/aei279","article-title":"Fluid Absorption in Endoscopic Surgery","volume":"96","author":"Hahn R. G.","year":"2006","journal-title":"British Journal of Anaesthesia"},{"issue":"5","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.accpm.2023.101290","article-title":"Perioperative Polyuria Associated With Dexmedetomidine Administration During Reconstruction Breast Surgery","volume":"42","author":"Rives J. P.","year":"2023","journal-title":"Anaesthesia, Critical Care & Pain Medicine"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcrc.2022.154233","article-title":"Diabetes Insipidus Related to Sedation in the Intensive Care Unit: A Review of the Literature","volume":"75","author":"Kraus M. B.","year":"2023","journal-title":"Journal of Critical Care"},{"issue":"4","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","DOI":"10.1177\/0300060520910643","article-title":"Intraoperative Dexmedetomidine\u2010Induced Polyuria From a Loading Dose: A Case Report","volume":"48","author":"Chen Z.","year":"2020","journal-title":"Journal of International Medical Research"},{"issue":"5","key":"e_1_2_13_10_1","article-title":"Intraoperative Dexmedetomidine\u2010Induced Polyuric Syndrome","volume":"9","author":"Granger S.","year":"2017","journal-title":"Cureus"},{"issue":"4","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/01.anes.0000281916.65365.4e","article-title":"Activation of a G Protein\u2010Coupled Inwardly Rectifying K+ Current and Suppression of Ih Contribute to Dexmedetomidine\u2010Induced Inhibition of Rat Hypothalamic Paraventricular Nucleus Neurons","volume":"107","author":"Shirasaka T.","year":"2007","journal-title":"Anesthesiology"},{"issue":"1","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0022-3565(24)36631-5","article-title":"Dexmedetomidine Inhibits Osmotic Water Permeability in the Rat Cortical Collecting Duct","volume":"281","author":"Rouch A. 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