Evidence map›Paper›PMID 38590100›Full record

ArticleTransfusion2024

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

Open access · greenAbstract read
In one paragraph

Article in Transfusion, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.2field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Review
  3. It's in your blood: The impact of age, sex, genetic factors and exposures on stored red blood cell metabolism.Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2024
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Devon GuerrelliChildren's National Heart Institute, Children's National Hospital, Washington, DC, USA.ORCID 0000-0003-0025-5997
Manan DesaiChildren's National Heart Institute, Children's National Hospital, Washington, DC, USA.
Youssef SemaanChildren's National Heart Institute, Children's National Hospital, Washington, DC, USA.
Yasin EssaChildren's National Heart Institute, Children's National Hospital, Washington, DC, USA.
David ZurakowskiDepartment of Anesthesiology, Critical Care and Pain Medicine, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Francesca CendaliDepartment of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Julie ReiszDepartment of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Angelo D'AlessandroDepartment of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.ORCID 0000-0002-2258-6490
Naomi LubanDepartment of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Nikki Gillum PosnackChildren's National Heart Institute, Children's National Hospital, Washington, DC, USA.ORCID 0000-0002-3880-7200
Children's National · USUniversity of Colorado Anschutz Medical Campus · USBoston Children's Hospital · US

Funding

Resuscitation Strategies for Achieving Thrombo-inflammatory HomeostasisRM1GM131968 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI COHEN, MITCHELL, D'ALESSANDRO, ANGELO · 2019 to 2023
$11.3M
The Impact of Oxidative Stress on Erythocyte BiologyR01HL148151 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI D'ALESSANDRO, ANGELO, KARAFIN, MATTHEW S · 2019 to 2022
$8.9M
The role of ferroptosis in red cell aging in vivo and in vitroR01HL146442 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI Angelo D'Alessandro, Adam N. Goldfarb · 2019 to 2026
$5.4M
Does Biocompatibility Contribute to Transfusion-Related Adverse Effects?R01HL139472 · NHLBI · CHILDREN'S RESEARCH INSTITUTE · PI Nikki Gillum Posnack · 2018 to 2026
$5.2M
The paradoxical response to iron in pulmonary hypertension of sickle cell diseaseR01HL161004 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI BUEHLER, PAUL WERNER, D'ALESSANDRO, ANGELO · 2022 to 2025
$2.7M
Interactions between the ADORA2b/Sphk1axis and the AE1-Hb switch in red blood cell aging in vivo and in vitroR01HL149714 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI D'ALESSANDRO, ANGELO · 2020 to 2023
$2.6M
Plastic Chemicals in Pediatric Cardiopulmonary Bypass: Evaluating Cardiac Toxicity and Investigating Clinical AlternativesF31HL165818 · NHLBI · CHILDREN'S RESEARCH INSTITUTE · PI GUERRELLI, DEVON · 2023 to 2025
$120k
NHLBI NIH HHS F31 HL165818NHLBI NIH HHS R01 HL139472NHLBI NIH HHS R01 HL146442NHLBI NIH HHS R01 HL148151NHLBI NIH HHS R01 HL149714NHLBI NIH HHS R01 HL161004NIGMS NIH HHS RM1 GM131968NIH HHS F31HL165818NIH HHS R01HL139472NIH HHS R01HL146442NIH HHS R01HL148151NIH HHS R01HL149714NIH HHS R01HL161004NIH HHS RM1GM131968
6 · The paper itself

Abstract

backgroundPhthalate 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

methodsThe 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.

resultsPatients 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.

Indexed as

Cardiopulmonary BypassAdolescentCardiac Surgical ProceduresChildChild, PreschoolDiethylhexyl PhthalateFemaleHumansInfantInfant, NewbornMalePhthalic AcidsPlasticsPrevalenceDiethylhexyl PhthalatePhthalic AcidsPlasticscardiopulmonary bypassdi(2‐ethylhexyl)phthalatepediatricphthalate plasticizersred blood cells

Identifiers

PMID38590100
PMCPMC12045462
OpenAlexW4394630417

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.