Naloxone for Opioid Overdose: Comment

Correspondence| April 2024 Naloxone for Opioid Overdose: Comment Gavin G. Pattullo, F.A.N.Z.C.A., F.F.P.M.A.N.Z.C.A. Gavin G. Pattullo, F.A.N.Z.C.A., F.F.P.M.A.N.Z.C.A. 1North Shore Private Hospital, Sydney, New South Wales, Australia. gavinpattullo@gmail.com Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information Accepted for publication December 7, 2023. Published online first on February 9, 2024.) Anesthesiology April 2024, Vol. 140, 856. https://doi.org/10.1097/ALN.0000000000004870 Connected Content Article: Opioid Overdose: Limitations in Naloxone Reversal of Respiratory Depression and Prevention of Cardiac Arrest Reply: Naloxone for Opioid Overdose: Reply Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Gavin G. Pattullo; Naloxone for Opioid Overdose: Comment. Anesthesiology 2024; 140:856 doi: https://doi.org/10.1097/ALN.0000000000004870 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search As clinicians, we often question why some patients respond to naloxone and others do not when opioid-induced ventilatory impairment is suspected. This inexplicability is disconcerting, given the toll of opioid-induced ventilatory impairment–related deaths. Our search for greater understanding, as recently provided in this Journal by van Lemmen et al.,1 is paramount. As minute ventilation falls under the influence of an opioid, the Pao2 will decline, and the Paco2 will rise.2 This relationship may be estimated in a perfect circumstance (without any contribution from shunt, for example) by the alveolar gas equation.3 A patient affected by opioid-induced ventilatory impairment breathing room air may present with an arterial oxygen saturation of 60% and a Paco2 100 mmHg estimated by the alveolar gas equation.4 Observational studies in human respiratory failure patients note aberrations of consciousness at Paco2 90 mmHg and... You do not currently have access to this content.