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Chemical can reproduce complications for some patients
Date:4/30/2009

n the production of polyvinyl chloride (PVC) medical devices, including IV fluid bags and EC circuits. CHX can migrate from PVC tubing and connections into fluids that come in contact with PVC. CHX can leach from PVC bags and IV tubing into intravenous fluids in sufficient concentrations to be detected in neonatal urine samples. Therefore, it is possible that patients on EC support are at risk for CHX exposure, given that their full blood volumes circulate continuously through CHX-treated tubing and are frequently augmented with IV fluids.

While the toxicity of PVC and CHX has been previously documented in animal models, no studies have made comparisons to clinical intravenous CHX exposure. Accordingly, the researchers developed a series of experiments to establish current values for CHX contamination in crystalloid fluid from IV bags and EC circuits, and to test the hypothesis that a clinically observed dose of CHX could reproduce the vital organ dysfunction that can accompany EC support/treatment.

Methodology

To quantify the degree of CHX contamination of fluids, researchers from Johns Hopkins Medical Institutions collected saline samples from IV bags and other commercially available bags, bypass circuits, ECMO circuits and dialysis circuits. CHX levels were measured using gas chromotography-mass spectrometry (GCMS). These results were used to determine a clinically relevant intravenous dose of CHX. A dose of CHX was then calculated and given intravenously to adult male rats. Saline stored in and administered from glass bottles was given to a control group. Dosing calculations were designed so that they approximated a conservative adult EC patient exposure to CHX, including the abrupt nature of the exposure that EC patients undergo when they are connect to circuit tubing.

There were three protocols used in the study:

Protocol 1 was designed to measure several aspects cardiovascular function. Animals were anes
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Contact: Donna Krupa
DKrupa@the-aps.org
301-634-7209
American Physiological Society
Source:Eurekalert

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