Self-defense sprays have been available to the general public since the 1970s. They are easily obtained and over 6 million spray units were sold in the United States in 1993 alone. The intent of these sprays is to cause skin and mucosal irritation without producing serious injury. We describe the accidental exposure to pepper-gas spray of an infant who experienced immediate life-threatening respiratory distress followed by progressive deterioration. Ultimately, he required extracorporeal membrane oxygenation (ECMO) for survival. The decision to place the infant on ECMO was made more difficult by the lack of information about potential reversibility with this rare toxic cause of respiratory failure.

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