Resuscitation
Volume 81, Issue 1 , Pages 42-46 , January 2010

Naloxone in cardiac arrest with suspected opioid overdoses

  • Matthew D. Saybolt

      Affiliations

    • UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ, USA
  • ,
  • Scott M. Alter

      Affiliations

    • UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ, USA
  • ,
  • Frank Dos Santos

      Affiliations

    • Department of Emergency Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
    • US Navy SUNY Maritime
  • ,
  • Diane P. Calello

      Affiliations

    • Department of Emergency Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
  • ,
  • Kevin O. Rynn

      Affiliations

    • Rutgers University, Ernest Mario School of Pharmacy, New Brunswick, NJ, USA
  • ,
  • Daniel A. Nelson

      Affiliations

    • UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ, USA
  • ,
  • Mark A. Merlin

      Affiliations

    • Department of Emergency Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
    • Corresponding Author InformationCorresponding author.

Received 2 March 2009 ,Revised 8 September 2009 ,Accepted 18 September 2009.

References 

  1. Martins HS, Silva RV, Dugano D, et al. Should naloxone be prescribed in the ED management of patients with cardiac arrest? A case reports and review of the literature. Am J Emerg Med. 2008;26:113.e5–113.e8
  2. Marsden AK, Mora FM. Case report—the successful use of naloxone in an asystolic pre-hospital arrest. Resuscitation. 1996;32:109–110
  3. Berlot G, Gullo A, Romano E, et al. Naloxone in cardiorespiratory arrest. Anaesthesia. 1985;40:819
  4. Rothstein RJ, Niemann JT, Rennie CJ, et al. Use of naloxone during cardiac arrest and CPR: potential adjunct for postcountershock electrical mechanical dissociation. Ann Emerg Med. 1985;4:198–203
  5. Wang Y, Gao L, Meng L. Small dose naloxone combined with epinephrine improves the resuscitation of cardiopulmonary arrest. Am J Emerg Med. 2008;26:898–901
  6. Wang Y, Gao L, Meng L. Naloxone combined with epinephrine decreases cerebral injury in cardiopulmonary arrest. J Emerg Med; in press.
  7. Chen MH, Liu TW, Xie L, et al. Does naloxone alone increase resuscitation rate during cardiopulmonary resuscitation in a rat asphyxia model?. Am J Emerg Med. 2006;24:567–572
  8. Janssen HF, Lutherer LO. Ventriculocisternal administration of naloxone protects against severe hypotension during endotoxic shock. Brain Res. 1980;194:608–612
  9. Meer KVD, Valkenburg PW, Bastiaans AC, et al. Effect of naloxone on blood pressure and survival in different shock models in rats. Eur J Pharmacol. 1986;124:299–308
  10. Foley PJ, Tacker WA, Voorhees WD, et al. Effects of naloxone on the adrenomedullary response during and after cardiopulmonary resuscitation in dogs. Am J Emerg Med. 1987;5:357–361
  11. Chen MH, Xie L, Liu TW, et al. Naloxone and epinephrine are equally effective for cardiopulmonary resuscitation in a rat asphyxia model. Acta Anaesthesiol Scand. 2006;50:1125–1130
  12. Estilo AE, Cottrell JE. Hemodynamic and catecholamine changes after administration of naloxone. Anesth Analg. 1982;61:349–353
  13. Lechner RB, Gurll NJ, Reynolds DG. Naloxone potentiates the cardiovascular effects of catecholamines in canine hemorrhagic shock. Circ Shock. 1985;16:347–361
  14. Boeuf B, Gauvin F, Guerguerian AM, et al. Therapy of shock with naloxone: a meta-analysis. Crit Care Med. 1998;26:1910–1916
  15. Boeuf B, Poirier V, Gauvin F, et al. Naloxone for shock. Cochrane Database of Syst Rev. 2003;CD004443
  16. Bone R, Jacobs E, Wilson F, et al. Naloxone reversal of hypotension: a clinical study. Am Rev Respir Dis. 1982;125:93
  17. Higgins TL, Sivak ED. Reversal of hypotension with naloxone. Clev Clin Q. 1981;48:283–288
  18. Holiday JW, Faden AI. Naloxone reversal of endotoxin hypotension suggests role of endorphins in shock. Nature. 1978;275:450–451
  19. Lu H, Xu G, Sheng Z. Clinical effects of naloxone on hemorrhagic shock. Chung Hua Wai Ko Tsa Chih. 1995;33:355–358
  20. Dixon R, Gentile J, Hsu HB, et al. Nalmefene: safety and kinetics after single and multiple oral doses of a new opioid antagonist. J Clin Pharmacol. 1987;27:233–239
  21. Wichmann MW, Zellweger R, Ayala A, et al. Effect of naloxone on immune responses after hemorrhagic shock. Crit Care Med. 2000;28:184–189
  22. Hiroshi E, Tadayuki H, Satomi O, et al. Naloxone improves arterial blood pressure and hypoxic ventilatory depression, but not survival, of rats during acute hypoxia. Crit Care Med. 2001;29:623–627
  23. Hung CF, Wu MH, Tsai CH, et al. Electrophysiological mechanisms for the antiarrhythmic activities of naloxone on cardiac tissues. Life Sci. 1998;63:1205–1219
  24. Gutstein H, Akil H. Opiod analgesics. In:  Hardman JG,  Limbird LE editor. Goodman and Gilmans. The pharmacological basis of therapeutics. 10th ed.. New York: McGraw-Hill; 2001;p. 569–619

 A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2009.09.016.

PII: S0300-9572(09)00492-4

doi: 10.1016/j.resuscitation.2009.09.016

Resuscitation
Volume 81, Issue 1 , Pages 42-46 , January 2010