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Cetrimide-chlorhexidine-induced multiorgan failure in surgery of pulmonary hydatid cyst


1 Department of Trauma and Emergency Medicine, AIIMS, Bhubaneswar, Odisha, India
2 Department of General Surgery, AIIMS, Bhubaneswar, Odisha, India
3 Department of Anaesthesia, AIIMS, Bhubaneswar, Odisha, India

Correspondence Address:
Swagata Tripathy
Department of Trauma and Emergency Medicine, AIIMS, Dumduma, Sijua, Bhubaneswar - 751 019, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.185565

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Year : 2016  |  Volume : 19  |  Issue : 3  |  Page : 557-560

 

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Savlon (0.5% cetrimide/0.05% chlorhexidine) is used as a scolicidal during surgery of hydatid cysts. It is considered a safe and effective agent. However, there are no recommendations for the appropriate concentration or dosage of these agents. Previously reported to cause severe metabolic acidosis, its effects on the pulmonary system have not been explored. We present a case of acute lung injury and respiratory distress along with acute cardiopulmonary distress, severe metabolic acidosis, and renal failure following its use during surgical removal of pulmonary hydatid cyst. The agent may act as a chemical sclerosant causing pulmonary parenchymal damage through bronchial openings present in the pericyst. Till safe dose limits are known, use of this agent should be limited, especially in large or multiple cyst surgery.






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1 Department of Trauma and Emergency Medicine, AIIMS, Bhubaneswar, Odisha, India
2 Department of General Surgery, AIIMS, Bhubaneswar, Odisha, India
3 Department of Anaesthesia, AIIMS, Bhubaneswar, Odisha, India

Correspondence Address:
Swagata Tripathy
Department of Trauma and Emergency Medicine, AIIMS, Dumduma, Sijua, Bhubaneswar - 751 019, Odisha
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.185565

Rights and Permissions

Savlon (0.5% cetrimide/0.05% chlorhexidine) is used as a scolicidal during surgery of hydatid cysts. It is considered a safe and effective agent. However, there are no recommendations for the appropriate concentration or dosage of these agents. Previously reported to cause severe metabolic acidosis, its effects on the pulmonary system have not been explored. We present a case of acute lung injury and respiratory distress along with acute cardiopulmonary distress, severe metabolic acidosis, and renal failure following its use during surgical removal of pulmonary hydatid cyst. The agent may act as a chemical sclerosant causing pulmonary parenchymal damage through bronchial openings present in the pericyst. Till safe dose limits are known, use of this agent should be limited, especially in large or multiple cyst surgery.






[FULL TEXT] [PDF]*


        
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