Fever, chills, and hypotension following cardiac catheterization with single- and multiple-use disposable catheters.

Recognition of pyrogen reactions in patients studied with multiple-use cardiac catheters led to recommendations regarding their cleaning and ultimately to the expensive practice of discarding catheters after a single use. Primarily because of cost considerations, our laboratory continued to clean and reuse catheters through 1981. This afforded an opportunity to assess the endemic rate of adverse reactions associated with this practice. We prospectively evaluated 341 patients who were studied with single-use or multiple-use catheters. The overall incidence of adverse reactions was: hypotension 27%, fever 3%, chills 3%, and all three 0.6%. There were no statistically significant increases in these reactions associated with the reuse of catheters. Bacterial infection did not appear responsible for these reactions, and it is possible that they were due to angiographic dye. We conclude that careful cleaning and reuse of catheters does not create an obvious increase in the risk of infection, and it appears to play a minor role, if any, in the development of other adverse reactions.