Hyperbaric oxygen therapy for the prevention of arterial gas embolism in food grade hydrogen peroxide ingestion

Hendriksen, Stephen; Menth, Nicholas L; Westgard, Bjorn; Cole, Jon B.; Walter, Joseph; Masters, T; Logue, Christopher

doi:10.1016/j.ajem.2016.12.027

Cited by 19 publications

(14 citation statements)

References 9 publications

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“…Since the male and female participants sample were not comparable awareness mothers' verses fathers. These results were contrast with another study was done in Netherland, nding of that study have shown that parents' awareness of adverse effect was good [13]. A similar situation, in Arab Emirates, Al Lela et al, (2014) pointed out parents' awareness about it associated risks was poor.…”

Section: Discussionmentioning

confidence: 68%

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

Perera¹,

Samarasekara²,

Shiwanth³

et al. 2020

Preprint

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Background: Corticosteroids are potent medications used to treat in many inflammatory conditions in paediatric neurology practice. Although corticosteroids are beneficial, their adverse effects may be numerous and vary. As parents are the primary caregivers of paediatric patients, assessing their awareness is timely important. Methods: To determine the parental awareness on adverse effects of corticosteroid therapy in Paediatric Neurology Patients in the Neurology Unit at the Lady Ridgeway Hospital, Colombo, Sri Lanka. In this descriptive cross-sectional study, 300 parents of paediatric neurology patients on long-term corticosteroid therapy in the paediatric neurology unit were included. Parents were volunteered for the study and signed informed consent. Ethical approval was obtained from the Ethics Review Committee of the same hospital. Data were collected using content validated, pre-tested self-administered questionnaire during January to March 2020. Results: Of the total parents, the majority were mothers (87%, n=262) and more than 70% (n=211) of them completed their secondary education. Findings demonstrated that parents had average awareness about adverse effects of long-term steroid therapy including child’s susceptibility to infections (69.0%, n=207), increase blood glucose levels (69.7%, n=209), moon face (60.3%. n=181), central obesity (60.3%, n=181), increase blood pressure levels (58.0%, n=174) and (irritability 50.3%, n=151) while poor awareness on adverse effects include buffalo humps (26.7%, n=80) increase fracture tendency (24.3%, n=73), tarry colour stools (24.3%, n=73), vision impairment (24.0%, n=72), glaucoma (17.3%, n=52), cataract (16.0%, n=48 ) and delayed wound healing (23.0%, n=69). According to the findings, overall mean (SD) knowledge percentage on parental awareness of adverse effects was found to be low (38.24 ± 20.57). Conclusion: Since parental awareness of the adverse effects of long-term corticosteroid therapy is inconsistent, special attention is needed to plan and implement appropriate awareness sessions.

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Section: Discussionmentioning

confidence: 68%

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

Perera¹,

Samarasekara²,

Shiwanth³

et al. 2020

Preprint

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“…Our patient did not present these major complications despite the relevant volume of highly concentrated HP ingested, making the choice of treatment uncertain. Actually, the role of HBOT in asymptomatic patients is not clear, as some patients treated conservatively were discharged without consequences [ 23 , 26 ], probably due to a more rapid scavenging of O 2 bubbles as compared with those containing N only as it occurs in diving accidents [ 23 ]; thus, the HBOT was performed more to prevent a systemic embolization (a PFO which was demonstrated in the following days) than to reduce the volume of gas bubbles located in the portal circulation, which often dissolve spontaneously [ 27 ]. An immediate treatment is not warranted in case of a VGA confined to the portal system; actually, the patient improved and her abdominal symptoms resolved completely even if the HBOT was initiated after as long as 7 hours from the ingestion of HP.…”

Section: Discussionmentioning

confidence: 99%

Uncommon Occurrences of Air Embolism: Description of Cases and Review of the Literature

Berlot

Rinaldi

Moscheni

et al. 2018

Case Reports in Critical Care

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Many different risk factors have been associated with the occurrence of gas embolism making this potentially lethal complication easily avoidable. However, this condition can occur in circumstances not commonly reported. Three different and extremely uncommon cases of gas embolism are presented and discussed: the first was caused by the voluntary ingestion of hydrogen peroxide, the second occurred during a retrograde cholangiopancreatography, and the last followed the intrapleural injection of Urokinase. Whereas in the first patient the gas embolism was associated with only relatively mild digestive symptoms, in the remaining two it caused a massive cerebral ischemia and an extended myocardial infarction, respectively. Despite a hyperbaric oxygen therapy performed timely in each case, only the first patient survived. The classical risk factors associated with gas embolism like indwelling central venous catheters, diving accidents, etc. are rather well known and thus somewhat preventable; however, a number of less common and difficult-to-recognize causes can determine this condition, making the correct diagnosis elusive and delaying the hyperbaric oxygen therapy, whose window of opportunity is rather narrow. Thus, a gas embolism should be suspected in the presence of not otherwise explainable sudden neurologic and/or cardiovascular symptoms also in circumstances not typically considered at risk.

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“…Mortality associated with hydrogen peroxide ingestion usually involves the formation of arterial gas emboli (AGE) and the development of cerebral embolism[ 1 - 3 ]. Perforation may occur, but is not as commonly described as AGE.…”

Section: Discussionmentioning

confidence: 99%

“…While neurological symptoms are definitive indications for HBT, its role in the presence of portal venous gas is still being evaluated[ 2 , 3 ]. Several centers with ready access to HBT have suggested that the mere presence of portal venous gas indicates need for HBT.…”

Section: Discussionmentioning

confidence: 99%

Hydrogen peroxide ingestion with injury to upper gastrointestinal tract

Martin¹,

Sugawa²

2017

WJCC

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Hydrogen peroxide is a common over-the-counter solution that has developed a growing body of literature regarding toxic ingestion. Intentional ingestion of high concentration hydrogen peroxide for health purposes has gained popularity in certain patient populations; purported benefits are due to the increased oxygen released into the blood stream. We present for evaluation one such case with associated imaging that presented to our urban medical center. A brief review of the literature was also performed noting current recommendations regarding both outcomes and indications for endoscopy as well as hyperbaric oxygen therapy following ingestion of hydrogen peroxide. Our patient was a 51-year-old white female who presented with foamy hematemesis after ingesting 10 drops of 35% hydrogen peroxide as part of a home remedy to cleanse her colon and improve blood oxygenation. In addition to hematemesis, she also reported diffuse abdominal pain with sore throat and hoarse voice. Her imaging demonstrated portal venous gas and gastric edema. She was admitted for hyperbaric oxygen therapy and underwent upper endoscopy demonstrating diffuse esophagitis and gastritis with white exudate and multiple petechiae. She was later discharged home in stable condition and was lost to follow-up.

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Hyperbaric oxygen therapy for the prevention of arterial gas embolism in food grade hydrogen peroxide ingestion

Cited by 19 publications

References 9 publications

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

Uncommon Occurrences of Air Embolism: Description of Cases and Review of the Literature

Hydrogen peroxide ingestion with injury to upper gastrointestinal tract

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