title: [Massive heroin intoxication. Hemodynamic studies].
abstract: Acute hemodynamic changes during heroin overdose have not been frequently reported. We observed 2 male patients aged 24 and 21 years admitted in coma and shock and presenting severe mixed acidosis, with, respectively, pH 6.80, PaCO2 72 mm Hg, PaO2 70 mm Hg, BE -18 mEq/l, lactic acid 16.5 mmol/l, and pH 6.86, PaCO2 94 mm Hg, PaO2 46 mm Hg, BE -16 mEq/l, lactic acid 5.45 mmol/l. The hemodynamic data of the first patient showed a low output failure state associated with high filling pressures, suggesting biventricular heart failure. In the second case, clinically and radiologically marked pulmonary edema was associated with a hyperdynamic state and moderately elevated pulmonary artery pressure, but normal pulmonary capillary pressure. The possible pathophysiological mechanisms of those different, hemodynamic patterns are discussed.
mesh_terms: D000138:Acidosis / Q000209:etiology; D000328:Adult; D001639:Bicarbonates / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006352:Heart Ventricles; D006439:Hemodynamics / Q000187:drug effects*; D003932:Heroin / Q000506:poisoning*; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects; D008297:Male; D011651:Pulmonary Artery; D011654:Pulmonary Edema / Q000139:chemically induced
chemical_list: D001639:Bicarbonates; D003932:Heroin
vernacular_title: Intoxication massive à l'héroïne. Etudes hémodynamiques.