Anesthesiology and Reanimation Department, Faculty of Medicine, İzmir Bakircay University, İzmir, Turkey.
Emergency Medicine Department, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
Int J Clin Pract. 2021 Oct;75(10):e14603. doi: 10.1111/ijcp.14603. Epub 2021 Jul 30.
It is commonly known that stored blood and blood products are heated before transfusion to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate (DEHP) content leaching into the blood and blood products and thereby causes greater conversion of DEHP to mono (2-ethylhexyl) phthalate (MEHP). However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension (ES) transfused via warming. In this study, we aimed to investigate the DEHP and MEHP content in blood following the heated ES transfusions administered by DEHP-containing and DEHP-free infusion sets.
The study included 30 patients that were randomly divided into two groups with 15 patients each: group I underwent ES transfusion via DEHP-containing infusion sets warmed with blood-fluid warmers, and group II underwent ES transfusion via DEHP-free infusion sets warmed with blood-fluid warmers. DEHP and MEHP levels were measured both before and after transfusion.
DEHP-free infusion sets led to no increase in the phthalate content, whereas DEHP-containing infusion sets significantly increased the DEHP and MEHP, where the DEHP level increased almost four times (P = .001).
DEHP-containing products lead to toxicity. Therefore, using DEHP-free medical devices may prevent toxicity in patients undergoing ES transfusion.
众所周知，为了防止体温过低，在输血前会对储存的血液和血液制品进行加热，这会导致更多的邻苯二甲酸二（2-乙基己基）酯（DEHP）浸出到血液和血液制品中，从而导致 DEHP 更大程度地转化为单（2-乙基己基）邻苯二甲酸酯（MEHP）。然而，目前尚无文献报道在通过加热输注红细胞悬液（ES）后血液中有毒邻苯二甲酸盐的含量。在这项研究中，我们旨在研究含 DEHP 和无 DEHP 的输液套装加热输血后血液中的 DEHP 和 MEHP 含量。
这项研究纳入了 30 名随机分为两组的患者，每组各 15 名：组 I 通过含有 DEHP 的输液套装输注 ES，并使用血液液体恒温器加热；组 II 通过无 DEHP 的输液套装输注 ES，并使用血液液体恒温器加热。在输血前后测量 DEHP 和 MEHP 水平。
无 DEHP 的输液套装不会增加邻苯二甲酸盐含量，而含有 DEHP 的输液套装则会显著增加 DEHP 和 MEHP，其中 DEHP 水平增加了近四倍（P=.001）。
含有 DEHP 的产品会导致毒性。因此，使用无 DEHP 的医疗设备可能会防止接受 ES 输血的患者发生毒性。
