RICHARD STRAUSS, M.D.
To the editor: I found the article by Higgins and colleagues (1) interesting and agree that their preliminary data provide evidence for the possible clinical use of naloxone in shock states. However, there are two points with which I take issue.
First, the authors point to a pulmonary capillary wedge pressure of 14 mm Hg as adequate evidence to exclude hypovolemia as a contributing factor to their patient's shock state without data on the amounts and results of their fluid challenges. It is difficult to know if this patient was euvolemic. Chronic and acute changes in ventricular compliance can manifest
STRAUSS R. Naloxone and Blood Pressure. Ann Intern Med. ;98:672–673. doi: 10.7326/0003-4819-98-5-672_3
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Published: Ann Intern Med. 1983;98(5_Part_1):672-673.
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