AI Summary & Key Takeaways
AI InsightIt is concluded that acute opiate intoxication treated in hospital has an excellent prognosis, provided by absence of cardiac arrest prior to admission.
📌 3 Key Takeaways
Abstract
We aimed to clarify complications and treatment of a case of pulmonary oedema developed due to acute heroin intoxication. Heroin lung rapidly causes a reversible form of pulmonary edema. Treatment is supportive and symptomatic. A 21 years old male patient with the history of heroin injection was presented with altered mental status. The patient was unconscious, and had myosis in pupils, respiratory depression, tachypnea, phyliform pulse (130/min), cyanosis (SpO_2 35%), and blood pressure of 40/? mmHg. He was immediately intubated, taken to the intensive care unit with the diagnosis of pulmonary edema and started to be ventilated mechanically. Naloxone was given with the total dose of 2 mg (0.8 mg/hr) for neurologic complications and treatment of pulmonary edema was started (oxygen enriched breathing air until the hypoxia has been abolished, and support of the circulation with reasonable liquid supply and infusion of inotropic drugs). Naloxone was given to reverse the respiratory and central nervous system depression. After 3 days of mechanical ventilatory support, the patient was extubated without any problem and taken to the service on fourth day. It is concluded that acute opiate intoxication treated in hospital has an excellent prognosis, provided by absence of cardiac arrest prior to admission.
Özet
Akut eroin İntoksikasyonuna bağlı gelişen pulmoner ödemli bir olgunun tedavisi ve komplikasyonları irdelenmiştir. Eroin aldığı ifade edilen bilinci kapalı, pupiller fiks ve miyotik, solunumu yüzeyel ve takipneik (SpO_2 % 35), nabız taşikardik filiform (130/dk), kan basıncı 40/? mmHg, ağrılı uyarana yanıtı olmayan 21 yaşındaki erkek olgu, entübe edilerek pulmoner ödem tanısıyla yoğun bakım ünitesine alınıp mekanik ventilasyona bağlandı. Olguya sıvı replasmanı yapıldı ve İV yoldan total 2.0 mg (0,8 mg/saat) nalokson verildi. Pulmoner ödem tedavisi için hipoksi ortadan kalkıncaya kadar % 100 O_2, sıvı replasmanı ve inotropik ajan verildi. Naloksan uygulaması eroinin solunum ve santral sinir sistemi üzerine olan etkilerini ortadan kaldırdı. Üç gün süre ile mekanik ventilasyon desteği sağlanan olgu, problemsiz olarak ekstübe edildi ve bir gün sonra servise gönderildi. Sonuç olarak, akut eroin intoksikasyonu ile gelen olgular kardiyak arrest geçirmeden hastaneye ulaştırılabilirse prognozun daha iyi olacağı kanısındayız.