Severe air embolism after surgical irrigation with hydrogen peroxide

BACKCROUND: Hydrogen peroxide is widely used for its antiseptic properties. In certain circumstances, however the risk of air embolism can create a li fe-threatening situation. CASE REPORT: A 16-year-oid adolescent required surgical treatment for femor otibial trauma. During the surgical procedure, cardiac arrest suddenly occu rred when hydrogen peroxide was being used to irrigate the wound. A central catheter was inserted and aspiration of air bubbles in the line led to the diagnosis of air embolism. Outcome was unfavorable despite successful resu scitation. A chronic neuro-vegatative state ensued and the patient died 8 m onths later. DISCUSSION: Several cases of air embolism have been described due to hydrog en peroxide in surgical, medical and accidental circumstances. Our case emp hasizes the potential danger of using hydrogen peroxide in certain situatio ns, including orthopedic surgery. Clinicians should he aware that hydrogen peroxide is not a perfectly safe product.