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Inducing Acute Lung Injury in Mice by Direct Intratracheal Lipopolysaccharide Instillation

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Published on: July 6, 2019

Morphine-induced acute lung injury.

Christian Hainer¹, Moritz N Wente, Peter J Hallscheidt

¹Department of Anaesthesiology, University of Heidelberg, D-69120 Heidelberg, Germany.

Journal of Clinical Anesthesia

|July 12, 2008

Summary

Familial adenomatous polyposis patients undergoing surgery may face acute lung injury. Continuous morphine administration before extubation might be a contributing factor, requiring further investigation into its mechanisms.

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Area of Science:

Gastroenterology
Critical Care Medicine
Pharmacology

Background:

Familial adenomatous polyposis (FAP) is a genetic disorder predisposing individuals to colorectal cancer and other gastrointestinal malignancies.
Pancreas-preserving duodenectomy is a surgical procedure for managing duodenal tumors or conditions like FAP.
Severe sepsis is a life-threatening condition characterized by organ dysfunction.

Observation:

A 38-year-old female patient with FAP developed severe sepsis post-pancreas-preserving duodenectomy.
The patient experienced acute lung injury during two separate attempts at tracheal extubation.
Continuous low-dose morphine was administered prior to each extubation attempt.

Findings:

The patient required reintubation due to acute lung injury following extubation attempts.
Morphine administration was noted before both extubation events that led to acute lung injury.
A potential link between morphine and the development of acute lung injury in this clinical context is suggested.

Implications:

This case highlights a potential adverse effect of morphine in critically ill patients with FAP undergoing major abdominal surgery.
Further research is warranted to elucidate the pathophysiologic and pharmacologic mechanisms by which morphine may contribute to acute lung injury.
Clinical vigilance is advised regarding opioid administration in post-operative patients, particularly those with complex medical histories and critical illness.