Protective actions of naloxone in hemorrhagic shock

The opiate antagonist, naloxone, was infused at 8 mg x kg-1 x h-1 in cats to determine its effect in hemorrhagic shock. Hemorrhaged cats treated with naloxone maintained postreinfusion mean arterial blood pressure at a higher value compared to those receiving only the vehicle. Final pressures were 77 +/- 9 mmHg for cats receiving vehicle compared to 120 +/- 6 mmHg for cats receiving naloxone. These values represent 58 +/-7 and 98 +/- 6% of initial pressures for vehicle- and naloxone-treated cats, respectively (P < 0.001). Naloxone also moderated increases in circulating lysosomal hydrolase activity (4- vs. 23-fold increase) and total plasma proteolysis (33 vs. 100% increase). Plasma myocardial depressant factor activity was also significantly reduced in naloxone-treated hemorrhaged cats compared to shock cats given 0.9% NaCl (16 +/- 3 vs. 58 +/- 4 U, respectively; P < 0.001). Studies on cat papillary muscles demonstrated that naloxone at concentrations slightly higher than estimated plasma values during shock exerted a moderate positive inotropic effect. Our results show that naloxone improved the hemodynamic and biochemical state of cats in hemorrhagic shock. Inhibition of proteolysis and stabilization of lysosomal membranes appear to be ivolved in the protective action of naloxone, along with the well-known opiate-antagonistic action of this agent.