Reversal of Hypotension by Continuous Naloxone Infusion in a Ventilator-Dependent Patient

Excerpt

The conventional treatment of hypotension due to septic, hypovolemic, or cardiogenic shock relies on attempted reversal of the primary cause, volume replacement, and use of pressor agents. Occasionally, patients fail to respond to this therapy; the release of endorphins has been implicated in severe shock. We treated a patient with congestive heart failure, respiratory failure, and profound hypotension unresponsive to conventional therapy. Because naloxone has been shown to correct hypotension in shock (1-3), we administered the agent first as an intravenous bolus and then as a continuous intravenous infusion, with favorable results.

An 80-year-old man who weighed 60 kg was