High-flow nasal cannula oxygen therapy in the management of acute respiratory distress syndrome secondary to opioid overdose
Department of Emergency Medicine, Adana City Training and Research Hospital, Adana, Turkey
Keywords: Acute respiratory distress syndrome, high-flow nasal cannula oxygen therapy, opioid overdose
In this article, we discuss the successful treatment of acute respiratory distress syndrome (ARDS), a rare complication of opioid overdose, through high-flow nasal cannula oxygen therapy (HFNCOT). A 32-year-old male patient was referred to the emergency department with an ambulance due to a state of confusion following intravenous opioid intake. On arrival, the patient had an arterial blood pressure of 100/60 mmHg, pulse of 112 beats/min, respiratory rate of 8 breaths/min, and oxygen saturation (SpO2) of 75%. On neurologic examination, he had miotic and isochoric pupils, and Glasgow Coma Score was 12 (E: 3 M: 5 V: 4). Cardiac examination showed that the heart was rhythmic and tachycardic. Chest examination revealed bibasilar crackles and wheezing. Naloxone was administered to the patient, and oxygen treatment was applied through a mask. Then, HFNCOT was commenced to the patient in whom the PaO2/FiO2 ratio in the blood gas was calculated as 141 following antidote treatment and whose chest radiograph showed bilateral infiltrations. The patient was discharged from the emergency critical care unit on the 3rd day of his hospitalization because infiltrations in his chest radiograph regressed. HFNCOT can recover the patient's hypoxemia and help reduce the necessity of mechanical ventilation in patients with mild or moderate ARDS.
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All the authors approved the final version to be published; all authors agreed to all aspects of the work. Study conception and design: MG, SS, and OY; Acquisition of data: MG, AA, OY, and SA; analysis and interpretation of data: MG, SS, and OY; drafting of manuscript: MG, SS, OY, SA, and AA; and critical revision: MG, SS, OY, SA, and AA. All authors read the manuscript and agreed to the content and data. All authors played a significant role in the article.