Brain lipid peroxidation and hydroxy radical attack following the intravenous infusion of hydrogen peroxide in an infant

Death following peroxide administration in humans has been reported repeatedly. Hydrogen peroxide, an odorless and clear solution is considered a harmless liquid and is in use for cleaning of superficial wounds. We describe the fatal infusion of this compound by mistake leading to oxygen embolism and, subsequently, to death as a warning for the clinician. Hydrogen peroxide is suggested a major substrate for the in vivo production of the potent oxidizing free radical species “hydroxy radical”. No direct evidence for its in vivo production from hydrogen peroxide has been described so far. Using the principle of o-tyrosine determination we studied the formation of the hydroxy radical in the postmortem brain of the infant given intravenous hydrogen peroxide in comparison to post-mortem brain samples from five infants. o-Tyrosine is formed by hydroxy radical attack on free and bound phenylalanine and was increased twofold in the brain of the infant given hydrogen peroxide. The significant increase of brain malondialdehyde, a major product and indicator of lipid peroxidation, paralleled the findings of hydroxy radical attack, suggesting that this reactive species has been leading to elevated lipid peroxidation. We propose that the generation of lipid peroxidation and the hydroxy radical from hydrogen peroxide can take place in humans.