Jenkins Randall, Ondusko Devlynne, Montrose Luke, Forbush Ryan, Rozansky David
Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA.
Department of Community and Environmental Health, Boise State University, Boise, ID 83725, USA.
Toxics. 2021 Apr 21;9(5):90. doi: 10.3390/toxics9050090.
Di-2-ethylhexyl phthalate (DEHP), a phthalate compound found in medical devices, may cause toxic effects in premature infants. In this study, the objective is to quantify DEHP exposures from various intravenous and respiratory therapy devices, and to use these values to predict typical exposure for an infant in a neonatal unit.
Common IV products used on infants are directed through various types of IV tubing (IVT) and analyzed for DEHP content. DEHP exposure for infants receiving respiratory therapy was determined indirectly through analysis of urine DEHP metabolites. By deriving these values for DEHP we calculated the daily exposure to DEHP from common IV fluids (IVF) and respiratory devices during hospitalization in a neonatal unit.
IVF labeled DEHP-positive showed very high concentrations of DEHP, but when passed through IVT, substantial amounts were adsorbed. DEHP was undetectable with all DEHP-negative IVF tests, except when passed through DEHP-positive IVT. The DEHP leached from most respiratory devices was relatively modest, except that detected from bubble CPAP. In 14 very low birthweight infants, the mean DEHP exposure was 182,369 mcg/kg over 81.2 days of the initial hospitalization. Ninety-eight percent of the exposure was from respiratory devices, with bubble CPAP accounting for 95% of the total DEHP exposure in these infants.
The DEHP exposure in our neonatal unit can be reduced markedly by avoiding or modifying bubble CPAP equipment and avoiding IV tubing containing DEHP.
邻苯二甲酸二（2-乙基己基）酯（DEHP）是一种在医疗设备中发现的邻苯二甲酸酯化合物，可能对早产儿产生毒性作用。在本研究中，目的是量化来自各种静脉和呼吸治疗设备的DEHP暴露，并使用这些值预测新生儿重症监护病房中婴儿的典型暴露情况。
将用于婴儿的常见静脉输液产品通过各种类型的静脉输液管（IVT），并分析其DEHP含量。通过分析尿液中的DEHP代谢物间接确定接受呼吸治疗的婴儿的DEHP暴露情况。通过得出这些DEHP值，我们计算了新生儿重症监护病房住院期间婴儿从常见静脉输液（IVF）和呼吸设备中每日的DEHP暴露量。
标记为DEHP阳性的IVF显示出非常高的DEHP浓度，但当通过IVT时，大量的DEHP被吸附。除了通过DEHP阳性的IVT时，所有DEHP阴性的IVF测试均未检测到DEHP。除了从气泡式持续气道正压通气（CPAP）设备检测到的DEHP外，大多数呼吸设备浸出的DEHP相对较少。在14名极低出生体重的婴儿中，在最初住院的81.2天内，平均DEHP暴露量为182,369微克/千克。98%的暴露来自呼吸设备，其中气泡式CPAP占这些婴儿总DEHP暴露量的95%。
通过避免或改进气泡式CPAP设备以及避免使用含有DEHP的IVT，我们新生儿重症监护病房中的DEHP暴露可显著降低。
