From the emergency department to veno-venous ECMO- a case of refractory hypoxia

Background: A known rare side effect of naloxone administration is non-cardiac pulmonary edema. There have been multiple proposed mechanisms for this, the most accepted one being a catecholamine surge causing physiologic changes favoring the development of pulmonary edema. The literature is sparse o...

Full description

Saved in:
Bibliographic Details
Main Authors: Joshua Fuller, Cameron Harrison
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JEM Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2773232025000379
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849688052129071104
author Joshua Fuller
Cameron Harrison
author_facet Joshua Fuller
Cameron Harrison
author_sort Joshua Fuller
collection DOAJ
description Background: A known rare side effect of naloxone administration is non-cardiac pulmonary edema. There have been multiple proposed mechanisms for this, the most accepted one being a catecholamine surge causing physiologic changes favoring the development of pulmonary edema. The literature is sparse on this clinical entity, mostly consisting of case reports and a case series. Case report: Here we present a case of a young male who presents with refractory hypoxia and shock requiring emergent Extracorporeal Membrane Oxygenation (ECMO) consultation and cannulation for veno-venous ECMO(VV-ECMO) from the emergency department. The patient responded well and was decannulated and extubated within 50 hours and ultimately discharged on hospital day 6. Why should an emergency physician be aware of this: This would be a rare publication of VV-ECMO being used emergently for hypoxic respiratory failure secondary to naloxone-induced pulmonary edema compounded by subsequent aspiration in the Emergency Department.
format Article
id doaj-art-ebc82ddd4cd84045989c0b6dee592eaa
institution DOAJ
issn 2773-2320
language English
publishDate 2025-06-01
publisher Elsevier
record_format Article
series JEM Reports
spelling doaj-art-ebc82ddd4cd84045989c0b6dee592eaa2025-08-20T03:22:09ZengElsevierJEM Reports2773-23202025-06-014210017310.1016/j.jemrpt.2025.100173From the emergency department to veno-venous ECMO- a case of refractory hypoxiaJoshua Fuller0Cameron Harrison1Corresponding author. University of Texas Health Science Center at San Antonio.; University of Texas Health Science Center at San AntonioUniversity of Texas Health Science Center at San AntonioBackground: A known rare side effect of naloxone administration is non-cardiac pulmonary edema. There have been multiple proposed mechanisms for this, the most accepted one being a catecholamine surge causing physiologic changes favoring the development of pulmonary edema. The literature is sparse on this clinical entity, mostly consisting of case reports and a case series. Case report: Here we present a case of a young male who presents with refractory hypoxia and shock requiring emergent Extracorporeal Membrane Oxygenation (ECMO) consultation and cannulation for veno-venous ECMO(VV-ECMO) from the emergency department. The patient responded well and was decannulated and extubated within 50 hours and ultimately discharged on hospital day 6. Why should an emergency physician be aware of this: This would be a rare publication of VV-ECMO being used emergently for hypoxic respiratory failure secondary to naloxone-induced pulmonary edema compounded by subsequent aspiration in the Emergency Department.http://www.sciencedirect.com/science/article/pii/S2773232025000379Veno-venous ECMONaloxonePulmonary edemaRefractory hypoxia
spellingShingle Joshua Fuller
Cameron Harrison
From the emergency department to veno-venous ECMO- a case of refractory hypoxia
JEM Reports
Veno-venous ECMO
Naloxone
Pulmonary edema
Refractory hypoxia
title From the emergency department to veno-venous ECMO- a case of refractory hypoxia
title_full From the emergency department to veno-venous ECMO- a case of refractory hypoxia
title_fullStr From the emergency department to veno-venous ECMO- a case of refractory hypoxia
title_full_unstemmed From the emergency department to veno-venous ECMO- a case of refractory hypoxia
title_short From the emergency department to veno-venous ECMO- a case of refractory hypoxia
title_sort from the emergency department to veno venous ecmo a case of refractory hypoxia
topic Veno-venous ECMO
Naloxone
Pulmonary edema
Refractory hypoxia
url http://www.sciencedirect.com/science/article/pii/S2773232025000379
work_keys_str_mv AT joshuafuller fromtheemergencydepartmenttovenovenousecmoacaseofrefractoryhypoxia
AT cameronharrison fromtheemergencydepartmenttovenovenousecmoacaseofrefractoryhypoxia