Naloxone-Induced Noncardiogenic Pulmonary Edema

Patti, Ravikaran; Ponnusamy, Vignesh; Somal, Navjot; Sinha, Ankur; Sharma, Shaurya; Yoon, Taek; Kupfer, Yizhak

doi:10.1097/mjt.0000000000001037

Cited by 5 publications

(2 citation statements)

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“…Pulmonary edema is a rare but well‐reported side effect of naloxone administration in adult patients. 7 , 8 , 9 Naloxone is thought to cause pulmonary edema due to increased catecholamine‐induced vasoconstriction resulting in significant fluid shifts. 10 Some studies have shown that higher doses of naloxone are associated with higher risk of pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

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Naloxone‐associated pulmonary edema in a 3‐year‐old with opioid overdose

2022

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Background Annually, close to 5000 children under age 6 years are treated in emergency departments or admitted for care due to opioid exposures. Naloxone is effectively used to treat opioid overdose in both children and adults. Non‐cardiogenic pulmonary edema is a rare but serious adverse effect of naloxone administration that has been reported in adults. Case Report We present the case of a 3‐year‐old male with suspected opioid overdose who developed acute hypoxia due to pulmonary edema after administration of naloxone following a likely prolonged downtime. Why Should an Emergency Physician Be Aware of This? The copious fluid in the airway made for difficult intubation at a pediatric tertiary care center. Given the incidence of opioid exposures in children, clinicians should be aware of this rare, but dangerous adverse effect of naloxone and consider airway precautions and pediatric critical care availability early in the presentation.

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Section: Discussionmentioning

confidence: 99%

“…Pulmonary edema is a rare but well‐reported side effect of naloxone administration in adult patients 7–9 . Naloxone is thought to cause pulmonary edema due to increased catecholamine‐induced vasoconstriction resulting in significant fluid shifts 10 .…”

Section: Discussionmentioning

confidence: 99%