Abstract

Nivez F. Rasic, Robert M. Friesen, Bruce Anderson, Shirley A. Hoban, Nancy Olson, Jacob Kress, Simon Lévesque, Martin R. Lessard, Pierre Nicole, Stéphan Langevin, Jacques Langevin, François LeBlanc (+429 others)
2003 Canadian Journal of Anesthesia  
The use of prepared endotracheal tubes (PETTs) for unanticipated difficult intubation is common. However, the storage time of PETTs is highly variable and institution dependent since there is no standardized protocol. We sought to determine firstly if open, unused PETTs are a potential source of pathogenic microorganisms and secondly if PETTs can provide a medium for bacterial survival after deliberate contamination. M ME ET TH HO OD DS S An intubating stylet was inserted into a 7mm ETT and
more » ... system was ethylene oxide sterilized. The PETTs were placed in twenty different locations, including 14 operating rooms, 4 labour and delivery suites and 2 epidural carts. In phase one, the PETTs (n=20) were sampled at time zero, 24, 48 and 72 hours, and 1, 2, 3, and 4 weeks. The presence or absence of growth was determined after 48 hours incubation and the microorganism identified. For phase two, the distal end of the PETT (n=40) was swabbed with a fresh suspension of H. influenzae, P. aeruginosa, S. aureus, E. faecium or a negative control. The sampling and culturing of the PETTs was repeated as described in phase one. R RE ES SU UL LT TS S Non-virulent bacteria were cultured from 13 of 160 (8.1%) samples and from 15 of 320 (4.7%) samples in phases one and two respectively. No PETT grew the same bacteria more than once. In phase two, E. faecium was consistently recovered from the PETTs throughout the one month period. After 24 hours, the other three microorganisms were not recovered. D DI IS SC CU US SS SI IO ON N Our findings suggest that the pathogenic potential of open, unused PETTs is very low. The practice of storing PETTs as back-up airway equipment for a period up to four weeks carries minimal risk of bacterial contamination. Based on this study PETTs can be safely used for up to one month. This practice could translate to significant cost reduction for operating room budgets. Apnea testing is an essential component for the confirmation of brain death. According to current guidelines, prevention of hypoxemia during the apneic period should be done by insufflation of 100% oxygen via a catheter inserted to the distal end of the endotracheal tube (ET). (1) Severe complications such as tension pneumothorax have been reported with this technique. (2) Alternate techniques of apneic oxygenation (T-piece or CPAP systems) could avoid such complications and are evaluated in this prospective cross-over study. ABSTRACT A5
doi:10.1007/bf03018160 fatcat:fbdbfhvcvzfyvgpudcwdrekwqi