Abstract
BACKGROUND: Many centers advocate the use of a standby wet-primed extracorporeal membrane oxygenation (ECMO) circuit for rapid deployment. Concerns with regard to the potential health hazards associated with the release of the plasticizer di-2(ethylhexyl)phthalate (DEHP) from the polyvinyl chloride (PVC) tubing exist. The purpose of this study is to determine the time course of DEHP release from a pre-primed ECMO circuit, and to evaluate the effect of PVC tubing coatings on DEHP release. METHODS: Seven test circuits including 3 uncoated (Medtronic, Medtronic with albumin, or Medtronic Super Tygon) and 4 coated (Carmeda, COBE Smart, Medtronic Trillium, or Terumo X-coated) were primed with Plasmalyte. Samples of the circuit prime were collected over a period of two weeks and were analyzed for DEHP utilizing gas chromatography. RESULTS: One coated (Carmeda) and all 3 uncoated circuits leached DEHP (Figure 1). The COBE Smart, Medtronic Trillium, and Terumo X-coated circuits had undetectable amounts of DEHP (p=0.006 vs Medtronic uncoated).FigureCONCLUSIONS: Pre-priming an ECMO circuit composed of uncoated PVC tubing is associated with DEHP release. Utilizing coated PVC tubing appears to eliminate DEHP release.
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