Pyrogenic reactions after inadvertent infusion of endotoxin during cardiac catheterizations.

Abstract:

:In April 1976 the attack rate of chills and fever with or without falls in blood pressure increased in association with cardiac catheterizations. Fevers were associated with coronary angiography and right and left heart catheterizations. Blood cultures were negative, and reactions did not correlate with amounts of contrast materials infused or with procedures done by a single operator. Significant numbers of Acinetobacter calcoaceticus (var. anitratus) and a Pseudomonas species were cultured from hospital-reservoir distilled water when it was flushed through a catheter before gas sterilization. This same water after ethylene oxide sterilization contained 2 x 10(5) ng/mL of endotoxin by limulus lysate test and was positive by rabbit pyrogen test. When washed reusable cardiac catheters were sterilized daily or when disposable catheters were substituted, febrile reactions ended. Pyrogenic reactions in patients undergoing cardiac catheterizations correlated with emptying retained endotoxin with injected contrast material from reused washed-sterilized catheters.

journal_name

Ann Intern Med

authors

Reyes MP,Ganguly S,Fowler M,Brown WJ,Gatmaitan BG,Friedman C,Lerner AM

doi

10.7326/0003-4819-93-1-32

subject

Has Abstract

pub_date

1980-07-01 00:00:00

pages

32-5

issue

1

eissn

0003-4819

issn

1539-3704

journal_volume

93

pub_type

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