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Anesth Analg 2004;99:1861-1863
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000135411.96718.AD

GENERAL ARTICLES

Venous Oxygen Embolism Produced by Injection of Hydrogen Peroxide into an Enterocutaneous Fistula

Philip M. Jones, MD, Steven H. Segal, FRCPC, and Adrian W. Gelb, FRCPC

University of Western Ontario, Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, Ontario

Address correspondence to Philip M Jones, 43 Cheswick Circle, London, Ontario, Canada, N6E 3L9. Address email to philipjones{at}tricolour.queensu.ca

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.

IMPLICATIONS: Hydrogen peroxide is used intraoperatively and perioperatively for the identification of fistula tracts. A venous oxygen embolism occurred in a 66-yr-old man after the intraoperative injection of 60 mL 3% hydrogen peroxide into an enterocutaneous fistula. The relevant aspects of the diagnosis and treatment of oxygen embolism are discussed.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2004 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.