Abstract
The presence of DEHP in dialysis and infusion sets for peritoneal dialysis and parenteral nutrition, which are made of PVC and other plastic polymeric materials, were investigated. Phthalate determination was carried out by gas chromatography - mass spectrometry method (GC-MS). The results showed that the peritoneal dialysis set (bag and tubing) made of PVC contains DEHP in significant amount, about 31 - 34%. Solution for peritoneal dialysis which was stored in the investigated PVC bag, contains low amount of DEHP, about 3.72 ?g dm-3. Infusion bottles which are made of LDPE, also contain DEHP but in lower amount than PVC bags. LDPE bottle for packaging physiological saline solution (0.9% NaCl) showed higher amount of DEHP than LDPE bottle for packaging Ringer?s solution. In contrast, solution stored in bottle with lower DEHP level, i.e. Ringer?s solution contained about three times higher concentration of DEHP than physiological saline solution stored in bottle with higher DEHP level. Concentrations of DEHP in Ringer?s solution and physiological saline solution are 17.30 and 5.83 ?g dm-3, respectively. The obtained values are under estimated upper-bound dose of DEHP received by adult patients undergoing procedures of peritoneal dialysis and parenteral nutrition.
Highlights
The presence of di-(2-ethylhexyl) phthalate (DEHP) in dialysis and infusion sets for peritoneal dialysis and parenteral nutrition, which are made of polyvinyl chloride (PVC) and other plastic polymeric materials, were investigated
Results obtained after performing Tukey’s post-hoc test shows that there is no significant difference between result obtained for 3 days extraction period and 6 day extraction period for dialysis bag, while for tubing from dialysis set, obtained results show that there are significant differences only between results obtained for 3 day extraction period and other extraction periods (6, 15 and 30 days)
A migration of DEHP from set for peritoneal dialysis that are made from PVC into dialysis solution and set for infusion parenteral nutrition that were made from low density polyethylene (LDPE) into infusion solutions has been investigated
Summary
The presence of DEHP in dialysis and infusion sets for peritoneal dialysis and parenteral nutrition, which are made of PVC and other plastic polymeric materials, were investigated. The results showed that the peritoneal dialysis set (bag and tubing) made of PVC contains DEHP in significant amount, about 31–34%. A lot of medical devices are made from PVC, such as intravenous bags and tubing, infusion tubing, blood bags, catheters, oxygen masks, peritoneal dialysis bags and tubing, enteral nutrition feeding bags, etc. Medical devices which contain phthalates may be important sources in susceptible subpopulations, including neonatal infants who are DEHP is not chemically bound to the polymer and it can migrate when the medical device comes into contact with certain media such as blood, drugs, saline or water. It can be caused through the induction of peroxisome proliferation, which leads to oxidative stress and the generation of electrophilic free radicals, and indirectly causing damage to DNA damage [14,15,16]
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