Vidil L, Racioppi L, Biais M, Revel P, Sztark F
Service d'anesthésie-réanimation-I, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
Ann Fr Anesth Reanim. 2008 Sep;27(9):735-7. doi: 10.1016/j.annfar.2008.06.008. Epub 2008 Aug 27.
We report a case of severe oxygen embolism after wound irrigation under pressure with hydrogen peroxide into a closed or partially closed cavity. The accident was observed during a surgical dressing of a large pelvis gangrene area, after a 250 ml injection of hydrogen peroxide. Suddenly occurred a decrease in PETCO(2) and SpO(2), and then heart arrhythmia. Symptomatic treatment initiated immediately restored SpO(2) and heart rhythm within a few minutes and the patient was then treated with hyperbaric oxygen therapy. The patient recovered without cardiac or neurologic sequelae. The release of gaseous oxygen under the effect of tissue catalase and the vascular diffusion of this oxygen bubbles can explain such complication. Injection of large volume of hydrogen peroxide into a closed or partially closed cavity and/or under pressure injection must be prohibited.
我们报告了1例在使用过氧化氢对封闭或部分封闭腔隙进行加压伤口冲洗后发生严重氧栓塞的病例。该意外发生在对一大块骨盆坏疽区域进行外科换药期间,注入了250ml过氧化氢之后。突然出现呼气末二氧化碳分压(PETCO₂)和血氧饱和度(SpO₂)下降,随后出现心律失常。立即开始的对症治疗在几分钟内恢复了SpO₂和心律,随后患者接受了高压氧治疗。患者康复,未留下心脏或神经后遗症。组织过氧化氢酶作用下气态氧的释放以及这些氧气泡的血管扩散可以解释这种并发症。必须禁止向封闭或部分封闭腔隙内注入大量过氧化氢和/或在压力下注入。