Naloxone-Induced Non-Cardiogenic Pulmonary Edema: A Case Report

Drug Safety - Case Reports
Nasheena JiwaRichard Silverman

Abstract

A 22-year-old man was admitted for an elective right-shoulder open subacromial decompression and distal clavicle excision. He received a single intravenous dose of fentanyl 50 μg for anesthesia. His procedure was completed without intra-operative complications; however, he developed post-operative respiratory depression in the setting of narcotic administration. He was given naloxone 0.2 mg intravenously once to reverse this effect, which subsequently led to acute hypoxic respiratory failure secondary to pulmonary edema shortly after administration of naloxone. His oxygen saturation was noted to be 50% on room air, he was tachypneic with a respiratory rate of 22, and his heart rate ranged from 89 to 104 beats per minute. His blood pressure remained within normal limits at 128/62. His chest X-ray was notable for patchy bilateral perihilar infiltrates and the patient was intubated postoperatively. An EKG revealed normal sinus rhythm, and cardiac enzymes were negative. He was diagnosed with naloxone-induced non-cardiogenic pulmonary edema supported by the temporal relationship of the causal drug and no other identifiable cause of his clinical picture. He received furosemide and underwent diuresis while intubated, with subsequent i...Continue Reading

References

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Citations

Jun 10, 2020·The Journal of Pharmacology and Experimental Therapeutics·Randy TorralvaAaron Janowsky
Dec 4, 2019·American Journal of Therapeutics·Ravikaran PattiYizhak Kupfer
Jan 16, 2021·Journal of the American College of Cardiology·Mori J KrantzMark C P Haigney
Sep 8, 2020·Critical Care Clinics·Eric J Lavonas, Cameron Dezfulian
Feb 9, 2021·Journal of Community Hospital Internal Medicine Perspectives·Sherif ElkattawyCarlos Remolina
Sep 14, 2020·The American Journal of Emergency Medicine·Daniel S BrennerLeah Bright
Aug 17, 2021·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Cameron UpchurchRobert G Hendrickson

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Methods Mentioned

BETA
sedation
X-ray

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