Journal of Community Hospital Internal Medicine Perspectives (Jan 2021)

Naloxone induced pulmonary edema

  • Sherif Elkattawy,
  • Ramez Alyacoub,
  • Chidinma Ejikeme,
  • Muhammad Atif Masood Noori,
  • Carlos Remolina

DOI
https://doi.org/10.1080/20009666.2020.1854417
Journal volume & issue
Vol. 11, no. 1
pp. 139 – 142

Abstract

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Naloxone-induced noncardiogenic pulmonary edema is a rare but reported entity that can occur following naloxone use in the reversal of opioid overdose. Proposed mechanisms include an adrenergic crisis secondary to catecholamine surge which causes more volume shift to pulmonary vasculature, subsequently leading to pulmonary edema. It appears to be more common when higher doses of naloxone are used. We present a case of a patient with opioid overdose came with altered mental status developed early features of pulmonary edema following the administration of multiple doses of naloxone. She responded well with the administration of diuretics and oxygen supplementation. Her oxygen requirements improved and didn’t require mechanical ventilation.

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