PDF(Pubmed)
Abstract：
Hydrogen peroxide is a chemical commonly used as a household antiseptic for cleaning and disinfecting. No cases of acute hydrogen peroxide inhalation-induced lung injury are previously described. We present a case of acute chemical pneumonitis caused by mixing hydrogen peroxide in a nighttime continuous positive airway pressure device\'s humidifier used for obstructive sleep apnea to prevent COVID-19 infection. The patient endorsed mixing hydrogen peroxide with distilled water in his nighttime continuous positive airway pressure device\'s humidifier at a ratio of 1:3-1:2 for the previous week before admission based on a friend\'s advice in preventing COVID-19. The presenting chest X-ray showed new multifocal consolidations with interstitial markings and alveolar edema throughout both lungs. Chest computed tomography (CT) imaging demonstrated multifocal, bilateral, hazy consolidations with increased interstitial markings and bilateral pleural effusions. The patient was subsequently initiated on systemic glucocorticoid therapy, significantly improving hypoxemia and dyspnea. Inhalation of hydrogen peroxide may produce acute pneumonitis distinct from what has been described previously with chronic inhalation. Given this case, systemic glucocorticoid therapy may be considered a viable treatment option for acute hydrogen peroxide-associated inhalation lung injury causing pneumonitis.
摘要：
过氧化氢是一种通常用作家用防腐剂的化学物质，用于清洁和消毒。以前没有描述急性过氧化氢吸入诱导的肺损伤病例。我们介绍了一例急性化学性肺炎的病例，该病例是在夜间连续气道正压通气装置的加湿器中混合过氧化氢引起的，该加湿器用于阻塞性睡眠呼吸暂停以防止COVID-19感染。患者在入院前的前一周，根据朋友的预防COVID-19的建议，同意在夜间持续气道正压通气装置的加湿器中以1：3-1：2的比例混合过氧化氢和蒸馏水。目前的胸部X线显示新的多灶性合并，在两个肺中都有间质标记和肺泡水肿。胸部计算机断层扫描（CT）成像显示多焦，双边,模糊合并，间质标记增加，双侧胸腔积液。患者随后开始全身糖皮质激素治疗，显著改善低氧血症和呼吸困难。过氧化氢的吸入可能会产生急性肺炎，这与先前描述的慢性吸入不同。鉴于这种情况,全身性糖皮质激素治疗可被认为是导致肺炎的急性过氧化氢相关吸入性肺损伤的可行治疗选择.
