Morphine in acute chronic obstructive pulmonary disease exacerbation

Correspondence to Dr Toru Kadowaki; kadowaki.toru.tu@mail.hosp.go.jp Description A 58-year-old man, awaiting lung transplantation, was admitted to our hospital with severe acute exacerbation of chronic obstructive pulmonary disease (COPD). Arterial blood gas analysis was performed while breathing O2...

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Bibliographic Details
Published in:BMJ case reports 2021-04, Vol.14 (4), p.e239739
Main Authors: Kadowaki, Toru, Yano, Shuichi
Format: Article
Language:English
Subjects:
Acute Disease
Case reports
Chronic obstructive pulmonary disease
Disease
Dyspnea
Humans
Images In
Morphine
Morphine - therapeutic use
Narcotics
Pulmonary Disease, Chronic Obstructive - drug therapy
Respiration, Artificial
Respiratory Insufficiency
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Summary:Correspondence to Dr Toru Kadowaki; kadowaki.toru.tu@mail.hosp.go.jp Description A 58-year-old man, awaiting lung transplantation, was admitted to our hospital with severe acute exacerbation of chronic obstructive pulmonary disease (COPD). Arterial blood gas analysis was performed while breathing O2 at 1 L/min through nasal prongs before taking oral morphine and was as follows: pH 7.31, PaCO2 56.3 mm Hg and PaO2 89 mm Hg. Opioids may have multiple mechanisms of action, including reducing ventilation and oxygen consumption, increasing sensitivity to hypercapnia, and reducing the central perception of dyspnoea and anxiety-associated dyspnoea.1 NIV is used to provide relief from dyspnoea.2 In the present case, the inspiratory and expiratory positive airway pressures were set at 12 cmH2O and 6 cmH2O, respectively, in the spontaneous mode.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-239739