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Preparation of Hydrogen Peroxide Solutions
Reagent grade 30% H2O2 is used to prepare our infusion solutions. Hydrogen peroxide, USP food or
cosmetic grades are avoided because they contain tin and phosphate compounds to stabilize the H2O2
molecule. Concentrated H2O2 solutions are powerful oxidizers and should be handled with caution.
The 30% H2O2 is diluted with equal amounts of sterile distilled water to make a 15% “stock” solution. The
stock solution is passed through a Millipore 0.22um medium flow filter for sterilization and removal of
particulate matter. The stock solution is stored in 100ml sterile containers and kept refrigerated ready for
future use. Our infusion solutions are prepared using sterile 5% dextrose in water. The addition of 1 ml
of the 15% H2O2 stock solution to each 100ml of carrier solution will produce a 0.15% concentration
used for intravenous infusions.
Studies on bubble formation with H2O2 in blood by Johnson30 found bubbles formed in concentrations
of 0.87 millimolar, but not at 0.69 millimolar. A 0.15% solution of H2O2 infused at the rate of 4 ml per
minute, assuming a blood flow rate of 100ml per minute, will give a 0.006 volumes percent blood
concentration. This produces 2.9 ml of oxygen per 100ml of blood.. Concentrations above 0.01 volume
percent cause bubble formation and are detrimental to capillary circulation. If we double our mixture
concentration to 0.3% it will effectively increase the oxygen produced from 2.9ml to 7.0ml per 100ml of
blood. This would produce a concentration of 0.012 volumes percent, exceeding the 0.01 volumes
percent found to cause bubble formation and capillary damage. The lungs are remarkable filters of
microbubbles49, however, their capacity can be exceeded and continuous infusions of 0.01 volumes
percent may lead to irreversible pulmonary damage and arterial embolism.
During our early studies of intravenous H2O2, an infusion of 0.3% may have produced hemoptysis in
one subject, although he had previously received five infusions of 0.3% without side effect. Several
investigators19,32,36 have used concentrations up to 0.48% intra-arterially without side effects, but we do
not recommend these concentrations.
Caution must be exercised that nothing is added to the H2O2 solution because of its tremendous
oxidizing power. Even ascorbic acid is rapidly oxidized to the monodihydroascorbate radical14, an
unstable compound which degrades into numerous other chemical fragments. A principle physiological
action of ascorbic acid in tissue, however, is through the formation of H2O258. Vitamins, minerals,
peptides, enzymes, amino acids, heparin, EDTA, or other injectible materials should never be mixed
with the H2O2 solution.
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