Venous oxygen embolism produced by injection of hydrogen peroxide into an enterocutaneous fistula.
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.
Jones
Philip M
PM
University of Western Ontario, Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, Ontario.
Segal
Steven H
SH
Gelb
Adrian W
AW
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
D002245:Carbon Dioxide; D006861:Hydrogen Peroxide; D010100:Oxygen