Methadone overdose
- PDF / 141,935 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 43 Downloads / 194 Views
1
OS
Adult respiratory distress syndrome: case report A methadone overdose led to adult respiratory distress syndrome in a 54-year-old man. The man presented to an emergency department with dyspnoea after ingestion of an unknown quantity of methadone [time to reaction onset not stated]; he had received high flow oxygen and salbutamol in transit. On arrival, his Glasgow Coma Score (GCS) was 9/15 with pinpoint pupils and he was in severe respiratory distress. His respiratory rate was 50 breaths/min and, while he maintained his own airway, he used accessory muscles for respiration. Generalised air entry was poor and widespread coarse crepitations were audible. Despite a fractional inspired oxygen of 0.8, his oxygen saturation decreased to 72%; he had a HR of 140 beats/min and a BP of 179/84mm Hg. Arterial blood gas analysis revealed a pH of 7.18, a PaCO2 of 10.11kPa and a PaO2 of 6.13kPa. Bilateral pulmonary oedema was observed on chest x-ray and an ECG showed sinus tachycardia. The man received IV naloxone and his GCS improved to 15/15; furosemide and glyceryl trinitrate were also administered . However, respiratory failure, hypoxia and tachypnoea persisted, and non-invasive ventilation via a facemask was commenced. His respiratory rate decreased to 24 breaths/min over the following hour; his PaCO2 and pH were 5.57kPa and 7.34, respectively. His GCS decreased to 14/15 and hypoxia with a PaO2 of 6.60kPa persisted. After three IV naloxone doses, a naloxone infusion was initiated to maintain a normal conscious level. With increased airway pressures, his PaO2 gradually increased to 23.96kPa and his respiratory rate continued to normalise. He was admitted for further care; 12 hours later, he was weaned onto high flow oxygen, as his pulmonary oedema gradually improved. Ridgway ZA, et al. Acute respiratory distress syndrome induced by oral methadone managed with non-invasive ventilation. Emergency Medicine Journal 24: 681, No. 801091847 9, 1 Sep 2007 - United Kingdom
0114-9954/10/1175-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 27 Oct 2007 No. 1175
Data Loading...
