title: [Risks of hydrogen peroxide irrigation in military surgery].
abstract: Two cases of severe complications due to injection of hydrogen peroxide under pressure into areas of muscular attrition in war wounds are reported. In both cases the administration of hydrogen peroxide was associated with tachypnoea, with major arterial desaturation and a precordial "mill-wheel" murmur was heard. In one case, these symptoms were followed by hemiplegia caused by paradoxical arterial gas embolism, and in the other case by a pulmonary oedema confirmed by computerized tomography. Both patients recovered under hyperbaric oxygen therapy. The release of gaseous oxygen under the effect of tissue catalase and the membrane peroxydasic activity of hydrogen peroxide initiate such complications. The injection of hydrogen peroxide under pressure into a closed or partially closed cavity should therefore be strictly prohibited.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Bégin.
authors.forename: J M
authors.initials: JM
authors.lastname: Saïssy
authors.forename: B
authors.initials: B
authors.lastname: Guignard
authors.forename: B
authors.initials: B
authors.lastname: Pats
authors.forename: B
authors.initials: B
authors.lastname: Lenoir
authors.forename: B
authors.initials: B
authors.lastname: Rouvier
mesh_terms: D000328:Adult; D004618:Embolism, Air / Q000209:etiology / Q000517:prevention & control; D005597:Fractures, Open / Q000150:complications / Q000188:drug therapy; D005602:France; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008887:Military Medicine; D012307:Risk Factors; D013352:Subcutaneous Emphysema / Q000209:etiology; D007507:Therapeutic Irrigation / Q000009:adverse effects; D014857:Warfare; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: D006861:Hydrogen Peroxide
vernacular_title: Risques de l'irrigation au peroxyde d'hydrogène en chirurgie de guerre.