title: Venous oxygen embolism produced by injection of hydrogen peroxide into an enterocutaneous fistula.
abstract: We report a venous oxygen embolism that occurred in a 66-yr-old man after 60 mL of 3% hydrogen peroxide was injected into a perianal fistula intraoperatively to locate its internal opening. The diagnosis was made after detecting hypoxemia, decreased end-tidal carbon dioxide tension, systemic hypotension, increased central venous pressure, and a new heart murmur. The patient recovered quickly and had no long-term sequelae. Oxygen embolism is a potentially fatal complication that can develop when hydrogen peroxide is used near venous spaces, and clinicians should be aware of the potential dangers when using this seemingly innocuous chemical.
authors.affiliation: University of Western Ontario, Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, Ontario.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Jones
authors.forename: Steven H
authors.initials: SH
authors.lastname: Segal
authors.forename: Adrian W
authors.initials: AW
authors.lastname: Gelb
mesh_terms: D000368:Aged; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood; D002496:Central Venous Pressure / Q000502:physiology; D003424:Crohn Disease / Q000150:complications; D004618:Embolism, Air / Q000209:etiology*; D006337:Heart Murmurs / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006861:Hydrogen Peroxide / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood*; D012003:Rectal Fistula / Q000175:diagnosis* / Q000601:surgery; D012126:Respiratory Dead Space / Q000502:physiology
chemical_list: D002245:Carbon Dioxide; D006861:Hydrogen Peroxide; D010100:Oxygen