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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Exposure to Di-(2-Ethylhexyl) Phthalate Among Premature Neonates in a Neonatal Intensive Care Unit
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Exposure to Di-(2-Ethylhexyl) Phthalate Among Premature Neonates in a Neonatal Intensive Care Unit

机译：在新生儿重症监护单位中暴露于过早的新生儿中的二苯甲酸酯

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Objective. Premature neonates who spend time in a neonatal intensive care unit may be at increased risk of adverse health effects from exposure to di-(2-ethylhexyl) phthalate (DEHP) because of their increased risk of high exposure, their small body size, and their physical condition. DEHP, a reproductive toxicant in animals, is a major component in polyvinyl chloride (PVC) plastics, which are frequently used in medical tubing and blood storage bags. DEHP is not covalently bound to PVC, and it may be easily released from the PVC medical devices. The objective of this study was to determine whether premature infants who undergo medical procedures, such as blood transfusions, intravenous therapy, enteral and parenteral nutrition support, and dialysis, are at increased risk of exposure to DEHP than the general population. Because of their smaller size, children and especially premature and small infants may receive a larger dose of DEHP on a milligram per kilogram basis than adults when the same-size medical device is used for all ages.Methods. Premature neonates who seemed to have the potential to be on intravenous infusion for 2 weeks and were expected to survive were eligible for enrollment in the study. We assessed exposure to DEHP in 6 premature newborns by measuring in 41 urine samples the levels of 3 DEHP metabolites: mono-(2-ethylhexyl) phthalate (mEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (mEHHP), and mono-(2-ethyl-5-oxohexyl) phthalate (mEOHP).Results. mEHHP and mEOHP were detected in all 41 urine samples, and mEHP was detected in 33. Because only 33 of the samples had detectable amounts for all 3 metabolites, statistical analyses were limited to those 33. The levels of all 3 DEHP metabolites varied widely, and the urinary mean and median concentrations of mEOHP and mEHHP were 1 order of magnitude higher than those for mEHP. Furthermore, the geometric mean urinary concentrations of mEOHP (1617 ng/mL), mEHHP (2003 ng/mL), and mEHP (100 ng/mL) in these 6 premature infants who underwent intensive therapeutic interventions were found to be severalfold higher than in the US general population (for mEHP, geometric mean in those 6 years and older was 3.43 ng/mL).Conclusions. This study provides the first quantitative evidence confirming that newborns who undergo intensive therapeutic medical interventions are exposed to higher concentrations of DEHP than the general population. Although the overall benefits of medical procedures using PVC devices outweigh the risks associated with exposure to DEHP, more research is needed to determine whether infants and children who undergo intensive therapeutic interventions using DEHP-containing devices are at higher risk for altered health outcomes than infants and children who undergo similar treatments but are not potentially exposed to DEHP.
机译：客观的。在新生儿重症监护病房中花费时间的早期新生儿可能会因暴露于二苯二甲酸二（2-乙基己基）（DEHP）而导致的不良健康影响的风险增加，因为它们的高暴露风险增加，它们的体积小和它们的风险健康状况。 Dehp是一种动物中的生殖毒物，是聚氯乙烯（PVC）塑料中的主要成分，其经常用于医用管和血液储存袋。 DEHP不与PVC共价绑定，并且可以容易地从PVC医疗器械释放。本研究的目的是确定接受医疗程序的早产儿，如输血，静脉治疗，肠内和肠胃外营养支持以及透析的风险增加到DEHP的风险而不是一般人群。由于其较小的尺寸，儿童和特别是早产儿，少剂量在每千克的毫克少量的米兰，而在相同尺寸的医疗装置用于所有年龄段。方法。早产儿，似乎有可能在静脉内输注> 2周内静脉注射，预计有资格在该研究中纳入。我们通过测量41尿液测量3 DeHP代谢物水平，评估6次早产新生儿的Dehp：单 - （2-乙基己基）邻苯二甲酸酯（MeHP），单 - （2-乙基-5-羟基己基）邻苯二甲酸酯（MeHHP），和单 - （2-乙基-5-氧己基）邻苯二甲酸酯（MeOHP）。结果。在所有41个尿液样品中检测到MeHHP和MeoHP，并且在33中检测到MeHP。由于所有3种代谢物只有33种可检测到的量，统计分析限于那些33.所有3个DeHP代谢物的水平广泛变化，泌尿均值和MeHHP的尿割器和中位数浓度高于MeHP的数量级。此外，在这6个早产儿的MeoHP（1617ng / ml），MeHHP（2003ng / ml）和MeHP（100ng / ml）中的几何平均尿浓度被发现，接受了强化治疗干预的早产儿高于美国一般人口（对于Mehp，在6岁及以上的几何平均值为3.43 ng / ml）.Conclusions。本研究提供了第一种定量证据，证实，经过强化治疗医疗医疗干预的新生儿暴露于比一般人群更高的DEHP浓度。尽管使用PVC器件的医疗程序的总体益处超过了与DEHP的暴露相关的风险，但需要更多的研究来确定使用含Dehp的设备进行密集的治疗性干预的婴儿和儿童是否具有比婴儿更容易改变的健康结果的风险更高。接受类似治疗但没有可能暴露在Dehp的儿童。

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