The safety of reused endotracheal tubes sterilized according to Centers for Disease Control and Prevention guidelines.

STUDY OBJECTIVE: To investigate safety issues associated with the reuse of sterilized endotracheal tubes (ETTs). DESIGN: Prospective, randomized study. SETTING: Laboratory in vivo testing. INTERVENTION: Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were inoculated onto ETT cuffs. Following inoculation, ETTs were sterilized with either ethylene oxide or glutaraldehyde. Cuffs were then swabbed and cultured for 24 hours. To examine changes in the physical integrities of sterilized ETT cuffs, ETTs were sterilized with ethylene oxide gas once, twice, or three times (the E1, E2, and E3 groups, respectively). Alternatively, ETTs were soaked in glutaraldehyde for 150, 300, 450, or 600 minutes (the G1, G2, G3, and G4 groups, respectively). MEASUREMENTS: Endotracheal tube cuffs were considered nonsterile if a visible colony of test organisms was cultured, and sterile if no colony was cultured. Changes in the physical integrity of sterilized ETT cuffs were determined by measuring changes in intracuff pressure or tensile strength. MAIN RESULTS: No growth of bacteria was observed in sterilized tubes. Endotracheal tube cuffs of the E1 and E2 groups showed almost the same physical integrity as those of the control group, whereas E3 group cuffs were softer than those of the untreated controls. Endotracheal tube cuffs of the G1 and G2 groups were harder than untreated controls; than of those of the G3 and G4 groups were similar to the controls. CONCLUSIONS: Endotracheal tubes can be reused sterilized safely. The physical integrity of ETT cuffs may be compromised by glutaraldehyde or ethylene oxide sterilization treatments.

An intraatrial thrombus and pulmonary thromboembolism as a late complication of percutaneous vertebroplasty.

Although percutaneous vertebroplasty is a simple and generally safe method for the management of vertebral compression fractures, cement leakage outside the vertebral body is a potential source of serious complications. We report a patient who presented with dyspnea and edema five years after percutaneous vertebroplasty and underwent open-heart surgery. This case demonstrates an intraatrial thrombus and pulmonary thromboembolism caused by venous leakage of polymethylmethacrylate as a late complication of the procedure.