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Opioids over dose...Why patient is hypoxic?

Hypoxemia if present in Opioids overdose has three differential diagnosis:


1-All of us know this differential ,HYPOVENTILATION


2-Another explanation is Pulmonary edema.  Hypothetical mechanisms for pulmonary edema in opioid overdose include negative pressure pulmonary edema from inspiring against a closed (collapsed) glottis.


3- Acute lung injury that is thought to occur in patients who are given reversal agents, in whom sudden sympathetic overactivity results in capillary leak in the lungs.


So next time you have hypoxemia in opioid overdosed patient,dont forget to listen to the lungs and to order X-ray to rule out any edema....
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