Abstract：
UNASSIGNED: Pulmonary edema is a rare complication occurring after naloxone administration, but the causal relationship remains insufficiently investigated. We aimed to determine the likelihood of naloxone as the causative agent in published cases of pulmonary edema.
UNASSIGNED: A literature search was conducted across multiple databases, utilizing database-specific search terms such as \"pulmonary edema/chemically induced\" and \"naloxone/adverse effects.\" Each case report was evaluated using the Naranjo scale, a standardized causality assessment algorithm.
UNASSIGNED: We identified 49 published case reports of pulmonary edema following naloxone administration. The median total dose of naloxone was 0.2 mg for patients presenting following a surgical procedure and 4 mg for out-of-hospital opioid overdoses. Based on the Naranjo scale, the majority of cases were classified as \"possible\" (n = 38) or \"probable\" (n = 11) adverse reactions, while no \"definite\" cases of naloxone-induced pulmonary edema were identified. Many patients were classified as \"possible\" due to limited patient information or other potential risks, such as fluid administration or airway obstruction. Forty-six of 49 patients survived (94 percent).
UNASSIGNED: Pulmonary edema may occur after both low and high doses of naloxone; however, low doses were primarily reported in the surgical population. Despite this complication, the majority of patients survived. Furthermore, no case report in our analysis was classified as a \"definite\" case of naloxone-induced pulmonary edema which limits the establishment of causality. Future studies should explore patient risk factors, including surgical versus outpatient setting and opioid-naïve versus opioid-tolerant for developing pulmonary edema and employ a causality assessment algorithm.
UNASSIGNED: These case reports suggest pulmonary edema can occur following naloxone administration, irrespective of dose. According to the Naranjo scale, there were no definite cases of naloxone-induced pulmonary edema. Overall, we suggest the benefits of naloxone administration outweigh the risks. Naloxone should be administered to treat opioid overdoses while monitoring for the development of pulmonary edema.
UNASSIGNED: A literature search was conducted across multiple databases, utilizing database-specific search terms such as \"pulmonary edema/chemically induced\" and \"naloxone/adverse effects.\" Each case report was evaluated using the Naranjo scale, a standardized causality assessment algorithm.
UNASSIGNED: We identified 49 published case reports of pulmonary edema following naloxone administration. The median total dose of naloxone was 0.2 mg for patients presenting following a surgical procedure and 4 mg for out-of-hospital opioid overdoses. Based on the Naranjo scale, the majority of cases were classified as \"possible\" (n = 38) or \"probable\" (n = 11) adverse reactions, while no \"definite\" cases of naloxone-induced pulmonary edema were identified. Many patients were classified as \"possible\" due to limited patient information or other potential risks, such as fluid administration or airway obstruction. Forty-six of 49 patients survived (94 percent).
UNASSIGNED: Pulmonary edema may occur after both low and high doses of naloxone; however, low doses were primarily reported in the surgical population. Despite this complication, the majority of patients survived. Furthermore, no case report in our analysis was classified as a \"definite\" case of naloxone-induced pulmonary edema which limits the establishment of causality. Future studies should explore patient risk factors, including surgical versus outpatient setting and opioid-naïve versus opioid-tolerant for developing pulmonary edema and employ a causality assessment algorithm.
UNASSIGNED: These case reports suggest pulmonary edema can occur following naloxone administration, irrespective of dose. According to the Naranjo scale, there were no definite cases of naloxone-induced pulmonary edema. Overall, we suggest the benefits of naloxone administration outweigh the risks. Naloxone should be administered to treat opioid overdoses while monitoring for the development of pulmonary edema.
摘要：
■肺水肿是纳洛酮给药后发生的罕见并发症，但因果关系仍未得到充分调查。我们旨在确定纳洛酮在已发表的肺水肿病例中作为病原体的可能性。
■在多个数据库中进行了文献检索，利用数据库特定的搜索术语，如“肺水肿/化学诱导”和“纳洛酮/不良反应”。“每个病例报告都使用Naranjo量表进行评估，标准化的因果关系评估算法。
■我们确定了49例纳洛酮给药后肺水肿的已发表病例报告。对于外科手术后出现的患者，纳洛酮的中位总剂量为0.2mg，对于院外阿片类药物过量，则为4mg。根据Naranjo量表,大多数病例被归类为“可能”(n=38)或“可能”(n=11)不良反应，而没有发现纳洛酮引起的肺水肿的“明确”病例。由于患者信息有限或其他潜在风险，许多患者被归类为“可能”。如液体管理或气道阻塞。49例患者中有46例存活（94％）。
■低剂量和高剂量纳洛酮都可能发生肺水肿；然而，低剂量主要在手术人群中报告.尽管复杂,大多数患者幸存下来。此外，在我们的分析中，没有病例报告被归类为纳洛酮诱导的肺水肿的“确定”病例，这限制了因果关系的建立。未来的研究应该探索患者的危险因素，包括手术与门诊患者和阿片类药物初治与阿片类药物耐受发生肺水肿,并采用因果关系评估算法.
■这些病例报告提示纳洛酮给药后可发生肺水肿，无论剂量。根据Naranjo量表,没有明确的纳洛酮诱导的肺水肿病例。总的来说,我们认为纳洛酮给药的益处大于风险.纳洛酮应用于治疗阿片类药物过量，同时监测肺水肿的发展。
■在多个数据库中进行了文献检索，利用数据库特定的搜索术语，如“肺水肿/化学诱导”和“纳洛酮/不良反应”。“每个病例报告都使用Naranjo量表进行评估，标准化的因果关系评估算法。
■我们确定了49例纳洛酮给药后肺水肿的已发表病例报告。对于外科手术后出现的患者，纳洛酮的中位总剂量为0.2mg，对于院外阿片类药物过量，则为4mg。根据Naranjo量表,大多数病例被归类为“可能”(n=38)或“可能”(n=11)不良反应，而没有发现纳洛酮引起的肺水肿的“明确”病例。由于患者信息有限或其他潜在风险，许多患者被归类为“可能”。如液体管理或气道阻塞。49例患者中有46例存活（94％）。
■低剂量和高剂量纳洛酮都可能发生肺水肿；然而，低剂量主要在手术人群中报告.尽管复杂,大多数患者幸存下来。此外，在我们的分析中，没有病例报告被归类为纳洛酮诱导的肺水肿的“确定”病例，这限制了因果关系的建立。未来的研究应该探索患者的危险因素，包括手术与门诊患者和阿片类药物初治与阿片类药物耐受发生肺水肿,并采用因果关系评估算法.
■这些病例报告提示纳洛酮给药后可发生肺水肿，无论剂量。根据Naranjo量表,没有明确的纳洛酮诱导的肺水肿病例。总的来说,我们认为纳洛酮给药的益处大于风险.纳洛酮应用于治疗阿片类药物过量，同时监测肺水肿的发展。
