Behrends Matthias, Beiderlinden Martin, Peters Jürgen
Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Essen, Germany.
Anesth Analg. 2005 Oct;101(4):1160-1162. doi: 10.1213/01.ANE.0000175774.33435.87.
We describe a case of acute lung injury following IV injection of peppermint oil. An 18-yr-old woman injected the oil and developed fulminant pulmonary edema requiring ventilator support. Within 4 h after injection her arterial oxygen tension was 8.1 kPa (60 mm Hg) at an inspired oxygen fraction (F(IO2)) of 0.7 (P/F ratio: 85) despite a positive end expiratory pressure (PEEP) of 20 mbar, therefore meeting criteria for acute respiratory distress syndrome (ARDS). Mean pulmonary artery pressures and pulmonary artery wedge pressures were within normal limits throughout the case (<25 mm Hg and <10 mm Hg, respectively). Ventilation with high PEEP and diuresis resulted in a P/F ratio of 265 after 24 h. The patient was successfully weaned from the ventilator on the 9th day. This report is the first description of the sequelae of IV peppermint oil injection. The injection resulted in pulmonary edema and acute lung injury, presumably due to direct toxicity and a resultant increase in pulmonary vascular permeability.
This report is the first description of IV peppermint oil injection. The patient rapidly developed severe fluid overload of the lung and subsequent lung injury that required intubation, mechanical ventilation, and intensive care therapy for 13 days. The pulmonary edema was presumably caused by direct toxicity and an increase in pulmonary vascular permeability.
我们描述了一例静脉注射薄荷油后发生急性肺损伤的病例。一名18岁女性注射该油后出现暴发性肺水肿，需要呼吸机支持。注射后4小时内，尽管呼气末正压（PEEP）为20毫巴，吸入氧分数（F(IO2)）为0.7，但她的动脉血氧分压为8.1千帕（60毫米汞柱）（P/F比值：85），因此符合急性呼吸窘迫综合征（ARDS）的标准。整个病例过程中平均肺动脉压和肺动脉楔压均在正常范围内（分别<25毫米汞柱和<10毫米汞柱）。高PEEP通气和利尿治疗24小时后P/F比值达到265。患者在第9天成功脱机。本报告首次描述了静脉注射薄荷油的后遗症。该注射导致肺水肿和急性肺损伤，可能是由于直接毒性作用以及由此导致的肺血管通透性增加。
本报告首次描述了静脉注射薄荷油的情况。患者迅速出现严重的肺部液体超负荷以及随后的肺损伤，需要插管、机械通气和重症监护治疗13天。肺水肿可能是由直接毒性作用和肺血管通透性增加引起的。
