Should naloxone be prescribed in the ED management of patients with cardiac arrest? A case report and review of literature

Martins, Herlon Saraiva; Silva, Roberta Vasconcelos; Bugano, Diogo Diniz Gomes; Santana, Alfredo Nicodemos Cruz; Brandão-Neto, Rodrigo Antônio; Giannini, Fabio; Scalabrini-Neto, Augusto; Velasco, Irineu Tadeu

doi:10.1016/j.ajem.2007.06.029

Cited by 8 publications

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“…One hypothesis is that hypoxia activates the endogenous opioid system, which is involved in the respiratory control system, stimulates catecholamine release and increases sympathetic nerve activity, thereby elevating heart rate and blood pressure (17). In addition, naloxone has possible anti-arrhythmic effects and ameliorates cardiac function, thereby most likely improving post-resuscitation myocardial dysfunction (21). Finally, naloxone has immunomodulatory effects and a possible protective role in postischemic heart injuries (21).…”

Section: Introductionmentioning

confidence: 99%

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Effects of terlipressin and naloxone compared with epinephrine in a rat model of asphyxia-induced cardiac arrest

Martins¹,

Koike²,

Velasco³

2013

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OBJECTIVE:To evaluate the hemodynamic and metabolic effects of terlipressin and naloxone in cardiac arrest.METHODS:Cardiac arrest in rats was induced by asphyxia and maintained for 3.5 minutes. Animals were then resuscitated and randomized into one of six groups: placebo (n = 7), epinephrine (0.02 mg/kg; n = 7), naloxone (1 mg/kg; n = 7) or terlipressin, of which three different doses were tested: 50 µg/kg (TP50; n = 7), 100 µg/kg (TP100; n = 7) and 150 µg/kg (TP150; n = 7). Hemodynamic variables were measured at baseline and at 10 (T10), 20 (T20), 30 (T30), 45 (T45) and 60 (T60) minutes after cardiac arrest. Arterial blood samples were collected at T10, T30 and T60.RESULTS:The mean arterial pressure values in the TP50 group were higher than those in the epinephrine group at T10 (165 vs. 112 mmHg), T20 (160 vs. 82 mmHg), T30 (143 vs. 66 mmHg), T45 (119 vs. 67 mmHg) and T60 (96 vs. 66.8 mmHg). The blood lactate level was lower in the naloxone group than in the epinephrine group at T10 (5.15 vs. 10.5 mmol/L), T30 (2.57 vs. 5.24 mmol/L) and T60 (2.1 vs. 4.1 mmol/L).CONCLUSIONS:In this rat model of asphyxia-induced cardiac arrest, terlipressin and naloxone were effective vasopressors in cardiopulmonary resuscitation and presented better metabolic profiles than epinephrine. Terlipressin provided better hemodynamic stability than epinephrine.

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Section: Introductionmentioning

confidence: 99%

“…In addition, naloxone has possible anti-arrhythmic effects and ameliorates cardiac function, thereby most likely improving post-resuscitation myocardial dysfunction (21). Finally, naloxone has immunomodulatory effects and a possible protective role in postischemic heart injuries (21). …”

Section: Introductionmentioning

confidence: 99%