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| Auteurs principaux: | , , , , , , , , , |
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| Format: | Artículo Open Access |
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Wiley
2024
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| Accès en ligne: | https://onlinelibrary.wiley.com/doi/10.1111/trf.17821 |
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| author | Devon Guerrelli Manan Desai Youssef Semaan Yasin Essa David Zurakowski Francesca Cendali Julie Reisz Angelo D'Alessandro Naomi Luban Nikki Gillum Posnack |
| author_facet | Devon Guerrelli Manan Desai Youssef Semaan Yasin Essa David Zurakowski Francesca Cendali Julie Reisz Angelo D'Alessandro Naomi Luban Nikki Gillum Posnack Devon Guerrelli Manan Desai Youssef Semaan Yasin Essa David Zurakowski Francesca Cendali Julie Reisz Angelo D'Alessandro Naomi Luban Nikki Gillum Posnack |
| collection | Wiley Open Access |
| contents | Prevalence and clinical implications of heightened plastic chemical exposure in pediatric patients undergoing cardiopulmonary bypass Devon Guerrelli Manan Desai Youssef Semaan Yasin Essa David Zurakowski Francesca Cendali Julie Reisz Angelo D'Alessandro Naomi Luban Nikki Gillum Posnack Transfusion Abstract Background Phthalate chemicals are used to manufacture plastic medical products, including many components of cardiopulmonary bypass (CPB) circuits. We aimed to quantify iatrogenic phthalate exposure in pediatric patients undergoing cardiac surgery and examine the link between phthalate exposure and postoperative outcomes. Study Design and Methods The study included pediatric patients undergoing (n=122) unique cardiac surgeries at Children's National Hospital. For each patient, a single plasma sample was collected preoperatively and two additional samples were collected postoperatively upon return from the operating room and the morning after surgery. Concentrations of di(2‐ethylhexyl) phthalate (DEHP) and its metabolites were quantified using ultra high‐pressure liquid chromatography coupled to mass spectrometry. Results Patients were subdivided into three groups, according to surgical procedure: (1) cardiac surgery not requiring CPB support, (2) cardiac surgery requiring CPB with a crystalloid prime, and (3) cardiac surgery requiring CPB with red blood cells (RBCs) to prime the circuit. Phthalate metabolites were detected in all patients, and postoperative phthalate levels were highest in patients undergoing CPB with an RBC‐based prime. Age‐matched (<1 year) CPB patients with elevated phthalate exposure were more likely to experience postoperative complications. RBC washing was an effective strategy to reduce phthalate levels in CPB prime. Discussion Pediatric cardiac surgery patients are exposed to phthalate chemicals from plastic medical products, and the degree of exposure increases in the context of CPB with an RBC‐based prime. Additional studies are warranted to measure the direct effect of phthalates on patient health outcomes and investigate mitigation strategies to reduce exposure. 10.1111/trf.17821 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/trf.17821 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_trf_17821 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Prevalence and clinical implications of heightened plastic chemical exposure in pediatric patients undergoing cardiopulmonary bypass Devon Guerrelli Manan Desai Youssef Semaan Yasin Essa David Zurakowski Francesca Cendali Julie Reisz Angelo D'Alessandro Naomi Luban Nikki Gillum Posnack Transfusion Prevalence and clinical implications of heightened plastic chemical exposure in pediatric patients undergoing cardiopulmonary bypass Devon Guerrelli Manan Desai Youssef Semaan Yasin Essa David Zurakowski Francesca Cendali Julie Reisz Angelo D'Alessandro Naomi Luban Nikki Gillum Posnack Transfusion Abstract Background Phthalate chemicals are used to manufacture plastic medical products, including many components of cardiopulmonary bypass (CPB) circuits. We aimed to quantify iatrogenic phthalate exposure in pediatric patients undergoing cardiac surgery and examine the link between phthalate exposure and postoperative outcomes. Study Design and Methods The study included pediatric patients undergoing (n=122) unique cardiac surgeries at Children's National Hospital. For each patient, a single plasma sample was collected preoperatively and two additional samples were collected postoperatively upon return from the operating room and the morning after surgery. Concentrations of di(2‐ethylhexyl) phthalate (DEHP) and its metabolites were quantified using ultra high‐pressure liquid chromatography coupled to mass spectrometry. Results Patients were subdivided into three groups, according to surgical procedure: (1) cardiac surgery not requiring CPB support, (2) cardiac surgery requiring CPB with a crystalloid prime, and (3) cardiac surgery requiring CPB with red blood cells (RBCs) to prime the circuit. Phthalate metabolites were detected in all patients, and postoperative phthalate levels were highest in patients undergoing CPB with an RBC‐based prime. Age‐matched (<1 year) CPB patients with elevated phthalate exposure were more likely to experience postoperative complications. RBC washing was an effective strategy to reduce phthalate levels in CPB prime. Discussion Pediatric cardiac surgery patients are exposed to phthalate chemicals from plastic medical products, and the degree of exposure increases in the context of CPB with an RBC‐based prime. Additional studies are warranted to measure the direct effect of phthalates on patient health outcomes and investigate mitigation strategies to reduce exposure. 10.1111/trf.17821 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Prevalence and clinical implications of heightened plastic chemical exposure in pediatric patients undergoing cardiopulmonary bypass |
| topic | Transfusion |
| url | https://onlinelibrary.wiley.com/doi/10.1111/trf.17821 |