Impact of non-di-(2-ethylhexyl)phthalate cardiopulmonary bypass tubes on inflammatory cytokines and coagulation-fibrinolysis systems during cardiopulmonary bypass.
Di-(2-ethylhexyl)phthalate (DEHP), an excellent plasticizer for poly(vinyl chloride) (PVC), is a known endocrine-disrupting chemical. This study was designed to investigate whether a new non-DEHP bilayer tube reduced the release of DEHP, suppressed inflammatory cytokines, and altered coagulation-fibrinolysis systems. Sixteen patients undergoing coronary artery bypass grafting (CABG) were randomly assigned to the non-DEHP bilayer group (group B, n = 8), or the noncoated PVC group (group N, n = 8). The level of DEHP in the blood was measured before and after cardiopulmonary bypass (CPB). The levels of interleukin-6 (IL-6), D-dimer, and thrombin-antithrombin complex (TAT) were also measured at six points during and after CPB. DEHP was significantly lower in group B (472 +/- 141 ng/ml) after CPB compared with group N (2094 +/- 1046 ng/ml). The IL-6 level was significantly lower in group B (151 +/- 131 pg/ml) than group N (206 +/- 224 pg/ml) 180 min after protamine administration. The D-dimer level was significantly lower in group B 60 min after protamine administration (6.2 +/- 2.4 microg/ml in group B vs 10.4 +/- 4.5 microg/ml in group N) and 180 min after protamine administration (4.4 +/- 0.7 microg/ml in group B vs 7.3 +/- 2.7 microg/ml in group N). Group B had a tendency toward reduced postoperative bleeding compared with group N at any time. The bilayer tube was superior to the noncoated tube in terms of the inhibition of DEHP release, inflammatory cytokines, and the fibrinolysis system.
Takahashi
Yosuke
Y
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan. ysk@msic.med.osaka-cu.ac.jp
Shibata
Toshihiko
T
Sasaki
Yasuyuki
Y
Fujii
Hiromichi
H
Ikuta
Takeshi
T
Bito
Yasuyuki
Y
Nakahira
Atsushi
A
Suehiro
Shigefumi
S
D000368:Aged; D000990:Antithrombin III; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D004051:Diethylhexyl Phthalate / Q000009:adverse effects* / Q000097:blood; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D010968:Plasticizers / Q000009:adverse effects* / Q000032:analysis; D011143:Polyvinyl Chloride; D019106:Postoperative Hemorrhage / Q000209:etiology*
D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D010968:Plasticizers; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D011143:Polyvinyl Chloride; D004051:Diethylhexyl Phthalate; D010447:Peptide Hydrolases