Acute Respiratory Distress Syndrome in a 28-Year-Old Male Subsequent to Inappropriate Naloxone Administration.

Abstract

Tramadol, a centrally-acting analgesic, is widely used for the management of moderate to severe pain. It is preferred in clinical settings due to its superior effectiveness and safety profile compared to other opioids. However, recent research has indicated a potential risk of tramadol-induced seizures, especially when consumed in high dosages or in combination with other substances. We present a case of a 28-year-old male who was brought to the Emergency Department approximately 30 minutes after administering 0.4 mg of naloxone intravenously by Emergency Medical Services (EMS) personnel. The administration was necessitated by a decline in the patient's level of consciousness, the onset of lip cyanosis, and suspected tramadol poisoning. The patient was intubated on-site before being transported to the Emergency Department. Upon arrival, despite receiving 40% FiO2, his O2 saturation was at 88%. Bibasilar crackles were detected during chest auscultation. A CT scan of his chest revealed the presence of bilateral alveolar infiltrates, primarily in the lower lobes. As a result, the patient was diagnosed with acute respiratory distress syndrome and was transferred to the intensive care unit for further care.