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Micronanoplastic exposure due to cardiopulmonary bypass in children: A prospective observational study.
Summary
A prospective observational study in children undergoing cardiac surgery with cardiopulmonary bypass (CPB) found measurable levels of micronanoplastics (MNPs) in blood samples collected after bypass. The study demonstrated that CPB circuits made of plastic components release MNPs directly into the bloodstream during surgery.
Cardiopulmonary bypass (CPB) is widely used in cardiac operations. However, it remains unclear whether a CPB circuit, which is mainly made of plastics, can release micronanoplastics (MNPs) into the bloodstream. We conducted a prospective observational study involving children undergoing congenital heart disease repair with CPB support. Blood samples were collected before and after CPB and analyzed using pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) and laser direct infrared spectroscopy (LDIR) in combination with scanning electron microscopy. A total of 22 patients were involved in this study. The Py-GC/MS analysis revealed a significant increase in total MNPs after CPB support (p < 0.0001). Notably, CPB support significantly increased the levels of polystyrene (p = 0.046), polyethylene (p = 0.038), polypropylene (p < 0.0001), polyvinyl chloride (p < 0.0001), and polyamide 6 (p = 0.027). CPB time was positively correlated to MNP exposure (r = 0.43, p = 0.047). Increases in MNP exposure were positively correlated to an increase in white blood cells (r = 0.52, p = 0.013) and neutrophils (r = 0.46, p = 0.029). The LDIR analysis found that the post-CPB count of MNPs was significantly higher than the pre-CPB count (p = 0.015). In conclusion, CPB support significantly increases exposure to MNP in children undergoing cardiac operations. Further investigations are warranted to clarify the long-term health risks of MNP exposure caused by CPB support.
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