title: Intravenous chlorhexidine gluconate causing acute respiratory distress syndrome.
abstract: METHODS
  A 67-year-old man undergoing a colectomy for colon cancer was unintentionally administered 0.8 mg of chlorhexidine gluconate intravenously and subsequently developed acute respiratory distress syndrome. The operation was discontinued immediately. Respiratory failure progressed despite three cycles of plasma exchange beginning on day 1. Extracorporeal membrane oxygenation for 72 h beginning on day 3 was associated with dramatic improvement. The patient showed complete recovery of intellectual function and subsequently underwent a colectomy with lymph node dissection for colon cancer.
  
  
  CONCLUSIONS
  For acute respiratory distress syndrome secondary to chlorhexidine gluconate intoxication, consideration should be given to the treatment of initial respiratory distress and subsequent pneumonia. The benefit of extracorporeal membrane oxygenation and plasma exchange may merit further investigation.
authors.affiliation: Tarumizu Central Hospital, Sakuragaoka, Kagoshima, Japan. ishiga@med2.kufm.kagoshima-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Ishigami
authors.forename: S
authors.initials: S
authors.lastname: Hase
authors.forename: H
authors.initials: H
authors.lastname: Nakashima
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.forename: H
authors.initials: H
authors.lastname: Dohgomori
authors.forename: S
authors.initials: S
authors.lastname: Natsugoe
authors.forename: T
authors.initials: T
authors.lastname: Aikou
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000506:poisoning*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000506:poisoning*; D003082:Colectomy; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008508:Medication Errors; D010951:Plasma Exchange; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; C010882:chlorhexidine gluconate; D002710:Chlorhexidine