title: Influence of lipid type on bis (2-ethylhexyl)phthalate (DEHP) leaching from infusion line sets in parenteral nutrition.
abstract: BACKGROUND
  Bis(2-ethylhexyl)phthalate (or DEHP) is widely used in polyvinyl chloride (PVC) tubings for its good plasticizing properties. Because it is not covalently bound to the plastic matrix, it is able to escape from PVC during the infusion of the lipid emulsions used in parenteral nutrition (PN). This creates a vector through which it can enter into contact with the patient via the nutrition admixtures infused. This study was designed to assess the potential role of the type of lipids used in PN admixtures on the quantity of DEHP leached out from PVC-based tubings.
  
  
  METHODS
  PVC-based infusion lines, 6 commercially available lipid emulsions, and their oil base components were left in direct contact, and the amount of DEHP leached was measured by liquid chromatography.
  
  
  RESULTS
  After a 24-hour exposure period, DEHP migration varied significantly (P = .0000152) according to lipid type. The olive oil-based emulsion Clinoleic leached the most DEHP (65.8 µg/mL intravenous fat emulsion), followed by the fish oil-based emulsion Omegaven (37.8 µg/mL). The soybean oil-based emulsions Intralipid, Medialipide, Lipidem, and Structolipid showed comparable performances, with DEHP leaching rates into the emulsion measured at 27.3, 27.8, 23.6, and 19.6 µg/mL, respectively. Results from the same experiments run on pure-form oils (soybean oil, olive oil, coconut oil, and cod liver oil) confirmed the influence of lipid type on DEHP leaching.
  
  
  CONCLUSIONS
  The major DEHP leaching caused by olive oil-based emulsions raises cause for concern because DEHP presents distinctive toxic effects, including an increased risk of cholestasis.
authors.affiliation: CHU Clermont-Ferrand, Department of Pharmacy, G Montpied Hospital, Clermont-Ferrand, France. sbagel@chu-clermontferrand.fr
authors.forename: Sandrine
authors.initials: S
authors.lastname: Bagel
authors.forename: Bérangère
authors.initials: B
authors.lastname: Dessaigne
authors.forename: Daniel
authors.initials: D
authors.lastname: Bourdeaux
authors.forename: Anne
authors.initials: A
authors.lastname: Boyer
authors.forename: Corinne
authors.initials: C
authors.lastname: Bouteloup
authors.forename: Jean-Etienne
authors.initials: JE
authors.lastname: Bazin
authors.forename: Jean
authors.initials: J
authors.lastname: Chopineau
authors.forename: Valérie
authors.initials: V
authors.lastname: Sautou
mesh_terms: D002853:Chromatography, Liquid; D000074263:Coconut Oil; D004041:Dietary Fats; D004051:Diethylhexyl Phthalate / Q000737:chemistry*; D005217:Fat Emulsions, Intravenous / Q000737:chemistry*; D005395:Fish Oils / Q000737:chemistry*; D006801:Humans; D000069463:Olive Oil; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010938:Plant Oils / Q000737:chemistry*; D011143:Polyvinyl Chloride / Q000737:chemistry*; D013024:Soybean Oil
chemical_list: D004041:Dietary Fats; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D000069463:Olive Oil; D010938:Plant Oils; D013024:Soybean Oil; D011143:Polyvinyl Chloride; D004051:Diethylhexyl Phthalate; D000074263:Coconut Oil