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Fentanyl patch abuse: naloxone complications and extracorporeal membrane oxygenation rescue.

Fentanyl patches offer a novel, but increasingly common method of drug abuse. We describe a patient who developed severe respiratory dysfunction after fentanyl patch abuse via insufflation, naloxone administration and aspiration. After other aggressive interventions failed to correct worsening hypoxemia, extracorporeal membrane oxygenation (ECMO) was initiated and led to complete recovery. To our knowledge, this is the 1st reported case of ECMO being used to correct severe pulmonary dysfunction associated with opioid abuse. The risks associated with naloxone administration are discussed.