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Acute lung injury after peppermint oil injection
Matthias Behrends1, Martin Beiderlinden, Jürgen Peters
1Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Essen, Germany.
Anesthesia and Analgesia
|September 30, 2005
Summary
Intravenous injection of peppermint oil can cause acute lung injury and severe pulmonary edema. This case highlights the potential dangers of injecting non-medical substances, emphasizing the need for caution.
Area of Science:
- Toxicology
- Pulmonology
- Emergency Medicine
Background:
- Intravenous (IV) administration of substances not intended for injection can lead to severe adverse events.
- Peppermint oil, commonly used for aromatherapy and ingestion, has not been previously documented as an IV injection substance.
Observation:
- An 18-year-old woman developed acute lung injury and fulminant pulmonary edema shortly after IV injection of peppermint oil.
- The patient required mechanical ventilation due to severe hypoxemia, meeting criteria for acute respiratory distress syndrome (ARDS).
Findings:
- The patient presented with a low P/F ratio (85) despite high positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (FIO2).
- Pulmonary artery pressures remained normal, suggesting the edema was not primarily cardiogenic.
- Treatment with PEEP and diuresis improved oxygenation (P/F ratio 265) within 24 hours.
Implications:
- This is the first reported case of acute lung injury and pulmonary edema following IV peppermint oil injection.
- The findings suggest direct toxicity of peppermint oil and increased pulmonary vascular permeability as the likely mechanisms.
- The case underscores the critical risks associated with non-medical IV substance administration.