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

1. Farkas A, Lynch MJ, Westover R, Giles J, Siripong N, Nalatwad A, Pizon AF, Martin-Gill C. 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.