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Pulmonary complications - aspiration, pulmonary edema, etc. are frequently reported in both heroin intoxication and in reversal of opioid overdose with naloxone.
Suspected opioid overdose victims (N=1831) who received naloxone from EMS providers were studied retrospectively. Pulmonary complications were defined as pulmonary edema, aspiration pneumonia and aspiration pneumonitis.
Results
- Out of hospital naloxone dose > 4.4 mg – 62% more likely of experiencing pulmonary complication (OR 2.14, 95% CI: 1.44 to 3.18)
- Increased risk of pulmonary complication if initial naloxone dose is > 0.4 mg (OR 2.57, 95% CI 1.45 to 4.54)
Conclusion
Higher out of hospital naloxone administration is associated with increased odds of developing pulmonary complications
References
- Pulmonary Complications of Opioid Overdose Treated With Naloxone. Ann Emerg Med. 2019 Jun 7;. doi: 10.1016/j.annemergmed.2019.04.
006. [Epub ahead of print] PubMed PMID: 31182316.