Evidence map›Paper›PMID 40188215›Full record

ArticlePediatric research2025

Cyclohexanone and metabolites exposure in critically Ill neonates and children.

Suneetha Desiraju, Emily Zhao, Jordan Kuiper, Cynthia F Salorio, David Graham, Jessie P Buckley, Mark W Russell, Eric M Graham, Danielle Gottlieb Sen, Gregory Ellis and 6 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Suneetha DesirajuDepartment of Pediatrics, Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Emily ZhaoJohns Hopkins University School of Medicine, Baltimore, MD, USA.
Jordan KuiperDepartment of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Cynthia F SalorioKennedy Krieger Institute, Baltimore, MD, USA.
David GrahamDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jessie P BuckleyDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Mark W RussellDepartment of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
Eric M GrahamDepartment of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA.
Danielle Gottlieb SenDepartment of Surgery, Division of Pediatric Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Gregory EllisDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Maureen GilmoreDepartment of Pediatrics, Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lauren JantzieDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sandra E JuulDepartment of Pediatrics, University of Washington, Seattle, WA, USA.
Kamala SimkhadaDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Allen D EverettDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Melania M BembeaDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. mbembea1@jhmi.edu.ORCID http://orcid.org/0000-0003-4984-520X

Funding

Biomarkers of Brain Injury in Critically-Ill Children on Extracorporeal Membrane Oxygenation (ECMO)R01NS106292 · NINDS · JOHNS HOPKINS UNIVERSITY · PI BEMBEA, MELANIA MARIA · 2019 to 2023
$3.1M
Role of Cyclohexanone Toxicity in Mediating Congenital Cardiac Surgery OutcomesR01HL158593 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI GRAHAM, DAVID R. M., JANTZIE, LAUREN LEIGH COONEY · 2022 to 2025
$2.9M
NHLBI NIH HHS R01 HL158593NINDS NIH HHS R01 NS106292
6 · The paper itself

Abstract

backgroundCyclohexanone is a volatile organic compound known to be toxic to humans and animals, used in the medical setting as a solvent sealer for intravenous (IV) fluid administration devices. We aimed to determine exposure sources as well as plasma and urine levels of cyclohexanone and metabolites in critically ill infants and children.

methodsWe prospectively enrolled children in a single center pediatric intensive care unit (ICU) (n = 66), and conducted a secondary analysis of a multicenter trial in premature neonates (n = 69). Cyclohexanone and its predominant metabolites, trans-1,2-cyclohexanediol and trans-1,4-cyclohexanediol, were measured serially in medical fluids, plasma, and urine.

resultsCyclohexanone was detected in all IV solutions used in standard ICU care (IV fluids, medications, dialysate and red blood cell bags, n = 53 fluid samples). Cyclohexanone and metabolites were higher in urine versus plasma in both cohorts. In premature neonates, plasma and urine cyclohexanone concentrations were highest on day of randomization, while metabolite concentrations were highest on days 7-14.

conclusionsCurrently, cyclohexanone may represent an inevitable exposure to children who require intensive care inclusive of IV fluid and medication administration devices. Further studies are needed to develop replacement or mitigation strategies for cyclohexanone exposure in the vulnerable neonatal and pediatric ICU populations. IMPACT: Direct bloodstream exposure to cyclohexanone in the hospital environment has been poorly described in the healthcare setting. Cyclohexanone was present in all tested types of intravenous solutions used in standard intensive care (intravenous fluids, medications, dialysate and stored red blood cell bags). In a single center pediatric intensive care unit cohort and a multicenter neonatal intensive care unit cohort, cyclohexanone and its metabolites were detected in every blood and urine sample tested. In a multicenter neonatal intensive care unit cohort, plasma and urine cyclohexanone concentrations were highest on day 1 of admission and metabolite concentrations were highest on days 7-14.

Indexed as

Critical IllnessCyclohexanonesChildChild, PreschoolFemaleHumansInfantInfant, NewbornInfant, PrematureIntensive Care Units, PediatricMaleProspective StudiescyclohexanoneCyclohexanones

Identifiers

PMID40188215
PMCPMC12353214

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.