Reversal of Hypotension by Continuous Naloxone Infusion in a Ventilator-Dependent Patient
Authors: THOMAS L. HIGGINS
Journal: Annals of Internal Medicine (1983)

Brief Reports1 January 1983Reversal of Hypotension by Continuous Naloxone Infusion in a Ventilator-Dependent PatientTHOMAS L. HIGGINS, M.D., EDWARD D. SIVAK, M.D., DENNIS M. O'NEIL, M.D., JOHN W. GRAVES, M.D., D. GREGORY FOUTCH, D.O.THOMAS L. HIGGINS, M.D.Search for more papers by this author, EDWARD D. SIVAK, M.D.Search for more papers by this author, DENNIS M. O'NEIL, M.D.Search for more papers by this author, JOHN W. GRAVES, M.D.Search for more papers by this author, D. GREGORY FOUTCH, D.O.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-1-47 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe conventional treatment of hypotension due to septic, hypovolemic, or cardiogenic shock relies on attempted reversal of the primary cause, volume replacement, and use of pressor agents. Occasionally, patients fail to respond to this therapy; the release of endorphins has been implicated in severe shock. We treated a patient with congestive heart failure, respiratory failure, and profound hypotension unresponsive to conventional therapy. Because naloxone has been shown to correct hypotension in shock (1-3), we administered the agent first as an intravenous bolus and then as a continuous intravenous infusion, with favorable results.An 80-year-old man who weighed 60 kg was...References1. PETERSJOHNSONWRIGHTMITCH WMRW. Correction of hypotension by naloxone [Abstract]. Clin Res. 1980;28:241A. Google Scholar2. TIENGO M. Naloxone in irreversible shock [Letter]. Lancet. 1980;2:690. CrossrefMedlineGoogle Scholar3. HIGGINSSIVAK TE. Reversal of hypotension with naloxone. Cleve Clin Q. 1981;48:283-6. CrossrefMedlineGoogle Scholar4. GUILLEMINVARGOROSSIER RTJ. β-endorphin and adrenocorticotropin are secreted concomitantly by the pituitary gland. Science. 1977;197:1367-9. CrossrefMedlineGoogle Scholar5. SHEAGREN J. Septic shock and corticosteroids [Editorial]. N Engl J Med. 1981;305:456-8. CrossrefMedlineGoogle Scholar6. FADENHOLADAY AJ. Experimental endotoxin shock: the pathophysiologic function of endorphins and treatment with opiate antagonists. J Infect Dis. 1980;142:229-38. CrossrefMedlineGoogle Scholar7. BASKINHOSOBUCHI DY. Naloxone reversal of ischaemic neurological deficits in man. Lancet. 1981;2:272-5. CrossrefMedlineGoogle Scholar8. SANTIAGOREMOLINASCOLESEDELMAN TCVN. Endorphins and the control of breathing: ability of naloxone to restore flow-resistive load compensation in chronic obstructive pulmonary disease. N Engl J Med. 1981;304:1190-5. CrossrefMedlineGoogle Scholar9. EINHORNYOUNGLANDSBERG DJL. Hypotensive effect of fasting: possible involvement of the sympathetic nervous system and endogenous opiates. Science. 1982;217:727-29. CrossrefMedlineGoogle Scholar10. JOHNSTONEJOBESKENNELL RDE. Reversal of morphine anesthesia with naloxone. Anesthesiology. 1974;41:361. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cleveland Clinic Foundation Cleveland, Ohio PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByNaloxone for shockTherapy of shock with naloxoneRole of Opioid Antagonists in the Therapy of Septic ShockNew Concepts in the Pharmacological Treatment of Cardiocirculatory Failure in Septic ShockDie Bedeutung der Opiatantagonisten bei der Behandlung des septischen SchocksNeue Konzepte bei der pharmakologischen Behandlung des Herz-Kreislauf-Versagens im septischen SchockPharmacotherapy of circulatory shockPharmacologic Management of the Critically III Patient in the Perioperative Period-Emphasis on the Sepsis SyndromeConsiderations in the Therapy of Septic ShockEarly use of naloxone in shock — A clinical trialSepsis and Pulmonary EdemaContinuous naloxone infusion in two neonates with septic shockEndogenous opiates: 1983Naloxone in shock and toxic comaBrain PeptidesBrain Peptides: What, Where, And Why?Naloxone and Blood PressureRICHARD STRAUSS, M.D.ENDOGENOUS OPIOID WITHDRAWAL IN THE JARISCH-HERXHEIMER REACTIONNaloxone and Septic ShockGEORGE S. HUGHES JR., M.D., R. STEPHEN PORTER, PHARM.D., RICHARD MARX, M.D., CHRIS C. HARKER 1 January 1983Volume 98, Issue 1Page: 47-48KeywordsHeart failureHypotensionPatientsRespiratory failureShock Issue Published: 1 January 1983 PDF DownloadLoading ...