Effects of administration of intravenous naloxone on gas exchange in brain-dead lung donors.
OBJECTIVE
To observe the effect of naloxone on the lung function of potential lung transplant donors with neurogenic pulmonary edema.


METHODS
Donors aged 16 to 55 years without any factors to contraindicate lung donation (pneumonia, pulmonary contusion, etc) were included. Ventilator settings were standardized to a tidal volume of 10 to 12 mL/kg, an FIO2 of 0.40, and a respiratory rate that kept PCO2 between 35 and 45 mm Hg. Chest physiotherapy, nebulizer treatments, and frequent suctioning were undertaken. Baseline arterial blood gas analysis and an oxygen challenge were performed. The patients were then given 8 to 10 mg of naloxone. Oxygen challenges and arterial blood gas analyses were repeated every 4 to 6 hours. The data were analyzed by using a paired t test, and each patient served as his or her own control.


METHODS
These interventions were performed on the 19 LifeQuest donors who met the set criteria from July 2002 to July 2004.


RESULTS
The PaO2 on the oxygen challenge immediately after administration of naloxone increased from 329 (SD 177) to 363 (SD 191) mm Hg, although the increase from baseline was not significant. The PaO2 from the second oxygen challenge (median time, 7 hours after administration of naloxone) increased to 413 (SD 177) mm Hg (P<.01).
Eagan
Christina
C
LifeQuest Organ Recovery Services, Gainesville, FL 32601, USA. eaganc@lifequest.ufl.edu
Keller
Cesar A
CA
Baz
Maher A
MA
Thibault
Michael
M
D000293:Adolescent; D000328:Adult; D001784:Blood Gas Analysis; D001926:Brain Death / Q000378:metabolism / Q000503:physiopathology; D046148:Donor Selection; D006801:Humans; D007262:Infusions, Intravenous; D016040:Lung Transplantation / Q000706:statistics & numerical data; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage* / Q000494:pharmacology; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000494:pharmacology; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration / Q000379:methods; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D056152:Respiratory Rate; D012138:Respiratory Therapy; D012189:Retrospective Studies; D013990:Tidal Volume; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods
D009292:Narcotic Antagonists; D009270:Naloxone; D010100:Oxygen