Peri-operative Exposure to Volatile Organic Compounds in Neonates Undergoing Cardiac Surgery
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3 2024
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Source: J Thorac Cardiovasc Surg. 167(3):1166-1176.e2
Details:
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Alternative Title:J Thorac Cardiovasc Surg
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Personal Author:
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Description:Objective:
Volatile organic compounds (VOCs) are used in the sterilization and manufacture of medical equipment. These compounds have high vapor pressures with low water solubility and are emitted as gases from solids or liquids. They can be mutagenic, neurotoxic, genotoxic, and/or carcinogenic. Safe limits of exposure are not known for neonates. This study examined determinants of exposure in newborns undergoing cardiac surgery.
Methods:
Twenty metabolites of 16 VOCs (e.g., xylene, cyanide, acrolein, acrylonitrile, N, N-dimethylformamide, 1,3-butadiene, styrene, and benzene) were measured as metabolites in daily urine samples collected from 10 neonates undergoing cardiac operations (n = 150 samples). Metabolites were quantified using reversed-phase ultra-high performance liquid chromatography and electrospray ionization tandem mass spectrometry. Repeated measures ANOVA was performed for each metabolite to examine associations with use of medical devices.
Results:
At least 3 metabolites were detected in every sample. The median number of metabolites detected in each sample was 14 (range: 3-15). In a model controlling for other factors, the use of extracorporeal membrane oxygenation was associated with significantly (p ≤ 0.05) higher metabolite levels of acrolein, acrylonitrile, ethylene oxide, propylene oxide, styrene, and ethylbenzene. Patients breathing ambient air had higher levels of metabolites of acrolein, xylene, N,N-dimethylformamide, methyl isocyanate, cyanide, 1,3-butadiene (all p≤ 0.05).
Conclusions:
Exposure to volatile organic compounds is pervasive in newborns undergoing cardiac surgery. Sources of exposure likely include medical devices and inhalation from the air in the intensive care unit. The contribution of VOC exposure during cardiac surgery in newborns to adverse outcomes warrants further evaluation.
Methods:
Twenty metabolites of 16 volatile organic compounds (VOCs) were measured as metabolites in daily urine samples collected from neonates undergoing cardiac operations. Metabolites were quantified using reversed-phase ultra-high performance liquid chromatography and electrospray ionization tandem mass spectrometry.
Results:
At least 3 VOC metabolites were detected in every sample. The median number of metabolites detected in each sample was 14 (range: 3-15). Levels varied by day of hospitalization, medical devices utilized, and exposure to ambient air.
Implications:
Exposure to volatile organic compounds is pervasive in newborns undergoing cardiac surgery. Sources of exposure likely include medical devices and inhalation from the air in the intensive care unit. The contribution of VOC exposure during cardiac surgery in newborns to adverse outcomes warrants further evaluation.
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Pubmed ID:37558202
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Pubmed Central ID:PMC11261308
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Funding:
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Volume:167
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Issue:3
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Supporting Files:No Additional Files