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2 "Acid-base imbalance"
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Pharmacology
Comparison of the efficacy of an infusion pump or standard IV push injection to deliver naloxone in treatment of opioid toxicity
Bita Dadpour, Maryam Vahabzadeh, Babak Mostafazadeh
Acute Crit Care. 2020;35(1):38-43.   Published online February 29, 2020
DOI: https://doi.org/10.4266/acc.2020.00010
  • 6,782 View
  • 166 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
The optimal goal of naloxone infusion in intensive care units is to ameliorate opioid-induced side effects in therapy or eliminate the symptoms of opioid toxicity in overdoses. Accurately monitoring and regulating the doses is critical to prevent adverse effects related to naloxone administration. The present study aimed to compare treatment outcomes when using two methods of intravenous naloxone infusion: an infusion pump or the standard method. Methods: This study involved 80 patients with signs and symptoms of opioid overdose. The patients were randomly assigned into two groups with respect to intravenous infusion of naloxone by either an infusion pump or the standard method. Results: Comparison of study parameters between the two groups at 12 and 24 hours after intervention showed significantly more compensatory acid-base imbalance in the naloxone infusion pump group. In the group that received naloxone by pump, only one patient experienced withdrawal symptoms, but withdrawal symptoms appeared in 12 patients (30.0%) in the standard intravenous infusion group within 12 hours and in seven additional patients (17.5%) within 24 hours of intervention. In the group receiving pump-based naloxone infusion therapy, no another complications were reported; however in the standard infusion group, the 12-hour and 24-hour complication rates were 55.0% and 32.5%, respectively. The length of hospital stay was 2.85±1.05 and 4.22±0.92 days for the pump and standard infusion groups, respectively (P<0.001). Conclusions: Naloxone infusion using an infusion pump may be safer with regard to hemodynamic stability, resulting in shorter hospitalization periods, and fewer posttreatment complications.

Citations

Citations to this article as recorded by  
  • Endogenous opiates and behavior: 2020
    Richard J. Bodnar
    Peptides.2022; 151: 170752.     CrossRef
  • Are opioid receptor antagonists adequate for “Opioid” overdose in a changing reality?
    John F. Peppin, Joseph V. Pergolizzi, Albert Dahan, Robert B. Raffa
    Journal of Clinical Pharmacy and Therapeutics.2021; 46(4): 861.     CrossRef
  • The Efficacy, Safety, and Convenience of a New Device for Flushing Intravenous Catheters (Baro Flush™): A Prospective Study
    Youn I. Choi, Jae Hee Cho, Jun-Won Chung, Kyoung Oh Kim, Kwang An Kwon, Han Yong Chun, Dong Kyun Park, Yoon Jae Kim
    Medicina.2020; 56(8): 393.     CrossRef
Diagnosis of Acid-base Imbalance by Stewart's Physicochemical Approach and Mortality Prediction in Severe Burn Patients with Inhalation Injury
Sunghoon Park, Cheol Hong Kim, In Gyu Hyun, Ki Suck Jung
Korean J Crit Care Med. 2006;21(1):17-27.
  • 2,395 View
  • 55 Download
AbstractAbstract PDF
BACKGROUND
Acid-base derangement are commonly encountered in critically ill patients. This study is to investigate underlying mechanisms of acid-base imbalance and also to examine whether they can predict mortality in burn patients.
METHODS
We retrospectively reviewed 73 severely burned patients who had admitted to burn intensive care unit, from January to July in 2004. All the patients had inhalation injury, identified by bronchoscopic examination. We analyzed the type and nature of the acid-base imbalances from arterial blood gas analysis, electrolytes and other biological tests between survivors and non-survivors for 30 days after admission.
RESULTS
Acidosis was the most common disorder during the early and late hospital periods. Large fractions of those showed decreased strong ion difference (SID), increased anion gap corrected by albumin (AGc) and [Cl-]corrected. Mixed disorder and alkalosis emerged after the 7(th) hospital day. As time went by, albumin, PaO2/FiO2 ratio, pH and SID were more decreased in non-survivors (n=28) than in survivors (n=45) while [Cl-] corrected, alveolar-arterial oxygen tension gradients, peripheral WBC counts and CRP were more increased in non-survivors than in survivors. In the area under the receiver operating characteristic curves for mortality prediction, APACHE II score and % of total body surface area (%TBSA) burn were high: 0.866 (95% CI; 0.785~0.946) for APACHE II score, 0.817 (95% CI; 0.717~0.918) for %TBSA burn.
CONCLUSIONS
In burned patients with inhalation injury, various types of acid-base imbalances and electrolytes abnormalities emerged after resuscitation and so, more careful attentions pursued for correcting underlying acid-base derangement.

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