Related Experiment Video

Updated: Dec 21, 2025

Mouse In Vivo Placental Targeted CRISPR Manipulation
07:39

Mouse In Vivo Placental Targeted CRISPR Manipulation

Published on: April 14, 2023

3.4K

Plasticizer exposure of infants during cardiac surgery

Elisabeth Eckert1, Johannes Müller1, Christine Höllerer1

  • 1Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 9-11, 91054 Erlangen, Germany.

Toxicology Letters
|May 11, 2020
PubMed

Insights

Infant patients undergoing cardiac surgery showed elevated internal exposure to the plasticizer DEHP (di-2-ethylhexyl phthalate) from blood bags, despite using alternative plasticizers in medical tubing. This highlights risks from standard medical procedures.

Area of Science:

  • Environmental Health
  • Toxicology
  • Pediatric Medicine

Background:

  • Plasticizers like DEHP (di-2-ethylhexyl phthalate) are widely used in medical devices, raising toxicological concerns, especially regarding endocrine disruption.
  • Infant patients undergoing cardiac surgery often require extensive medical interventions, including blood product transfusions and the use of plasticized medical equipment.

Purpose of the Study:

  • To investigate the internal exposure levels of plasticizers tri-2-ethylhexyl trimellitate (TEHTM) and DEHP in infant patients before and after cardiac surgery.
  • To assess the contribution of standard medical procedures, specifically cardio pulmonary bypass (CPB) and blood product storage, to plasticizer burden in infants.

Main Methods:

  • Analysis of blood and urine samples from 21 infant patients (aged 2-22 months) undergoing cardiac surgery.
  • Quantification of TEHTM and DEHP and their metabolites using pre- and post-surgery samples.
  • Utilized CPB tubings plasticized with TEHTM and blood bags plasticized with DEHP.

Main Results:

  • Elevated levels of DEHP (median 1046 μg/L) were detected in post-surgery blood samples, while TEHTM levels were low (median 18.4 μg/L).
  • DEHP metabolites were found in all post-surgery urine samples, with a significant increase (5-26 fold) compared to pre-surgery levels.
  • TEHTM metabolites were not detected in any urine samples.

Conclusions:

  • Standard medical procedures, particularly the use of DEHP-plasticized blood bags, significantly contribute to the internal plasticizer burden in infant patients.
  • The elevated internal levels of DEHP and its metabolites in infants post-cardiac surgery are concerning due to its suspected endocrine-disrupting properties.

Keywords:
BiomonitoringCardio pulmonary bypassDEHPMedical devicesPacked red blood cellsTOTMUrine

More Related Videos

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats07:36

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

11.7K
Using Chicken Embryo as a Powerful Tool in Assessment of Developmental Cardiotoxicities11:00

Using Chicken Embryo as a Powerful Tool in Assessment of Developmental Cardiotoxicities

Published on: March 21, 2021

4.7K

Related Concept Videos

Plasticizers01:31

Plasticizers

Water-reducers, or plasticizers, are chemical admixtures used in concrete to improve strength and workability. These additives reduce the water-cement ratio without compromising workability, lower the cement content while maintaining the same workability, or increase workability to assist concrete placement in inaccessible areas.
Plasticizers function by using surface-active agents to create repulsive electrostatic forces between cement particles. This dispersion enhances the concrete's...
260
Superplasticizers01:30

Superplasticizers

Superplasticizers are advanced admixtures that enhance the workability of concrete by lowering the water content without compromising the strength of the material. These substances are highly effective water reducers, improving concrete flow, making it easier to work with, and enabling concrete to reach inaccessible areas or densely reinforced sections without mechanical vibration. The key components in superplasticizers are either sulfonated melamine or naphthalene formaldehyde condensates,...
221
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
3.8K
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
169
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
190
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
172