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Naloxone in septic shock.

K V Hackshaw1, G A Parker, J W Roberts

  • 1Department of Medicine, College of Physicians and Surgeons of Columbia University, Harlem Hospital, New York, NY.

Critical Care Medicine
|January 1, 1990
PubMed
Summary
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Naloxone administration in septic shock patients significantly increased mean arterial pressure (MAP) and systolic blood pressure. While not impacting survival, naloxone may temporarily stabilize critical patients.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Cardiovascular Physiology

Background:

  • Septic shock treatment remains challenging, with variable success rates for agents like naloxone.
  • Optimizing naloxone dosage and timing is crucial for its efficacy in managing septic shock.

Purpose of the Study:

  • To investigate the effects of a specific naloxone dosage and infusion protocol on hemodynamics in patients with septic shock.
  • To evaluate naloxone's impact on mean arterial pressure (MAP) and other hemodynamic parameters.

Main Methods:

  • Thirteen septic shock patients received an initial naloxone bolus (0.03 mg/kg) followed by a one-hour infusion (0.2 mg/kg/h).
  • Invasive hemodynamic monitoring was employed, with stable fluid administration, pressor agents, and ventilator settings during the naloxone infusion period.

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Main Results:

  • Significant increases in mean arterial pressure (MAP) and systolic arterial pressure were observed post-naloxone administration.
  • Moderate, non-significant increases in cardiac index, pulmonary capillary wedge pressure, and systemic vascular resistance were noted.
  • No adverse side-effects related to naloxone were reported in the study group.

Conclusions:

  • Naloxone administration led to a significant, albeit temporary, increase in MAP in septic shock patients.
  • While naloxone did not demonstrate an effect on overall survival in this study, it may serve as a temporizing measure in critically ill patients.
  • Further research is warranted to explore naloxone's role in septic shock management and its potential as a supportive therapy.