Treatment of refractory lobar atelectasis in amyotrophic lateral sclerosis with PEEP.

COMMUNICATIONSTO THE EDITOR 353 1) wiping the insertion tube with a 20 percent povidone iodine scrub solution. 2) suctioning iodine scrub solution through the biopsy channel and cleaning the channel with the cleaning brush. 3) suctioning sterile water through the channel. 4) suctioning freshly activated gluteraldehyde through the channel and soaking the entire insertion tube for 10 minutes. 5) rinsing the insertion tube with 200 ml of sterile water. 6) air drying the biopsy channel. Repeat cultures of the biopsy channel yielded heavy growth of both Serratia and Pseudomonas. The insertion tube was then resoaked in gluteraldehyde for an additional 20 minutes, and cultures were still positive. Only after an additional 45 minutes in gluteraldehyde were the cultures negative, Because many of the patients in our Burn Center have either colonized or are infected with antibiotic-resistant organisms, and our recent experience has demonstrated that recommended methods of disinfection may not be effective, we are now sterilizing the fiberoptic bronchoscope in ethylene oxide gas after every use.