Complications
Opioids cause bradypnea and apnea. If oxygenation and ventilation are not restored, either by artificial means or by antidote administration, hypoxia and hypercarbia will ensue. This can result in permanent neurologic damage or hypoxic cardiac arrest.
Unfortunately, this most often occurs outside the healthcare facility, where physicians are unable to intervene and prevent these complications.
The central nervous system depression and loss of gag reflex associated with opioid overdose puts patients at risk for aspiration of gastric contents and subsequent pneumonia.
The etiology of acute respiratory distress syndrome in opioid overdose is unclear.
The treatment is mainly supportive, with supplemental oxygen and mechanical ventilation in severe cases.
It is unclear whether diuretics are useful in the treatment of acute respiratory distress syndrome from opioids.
Noninvasive positive pressure ventilation techniques may be useful in patients with moderate hypoxia.
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