Particle Spallation and Plasticiser (DEHP) Release from Extracorporeal Circuit Tubing Materials

Particle spallation and plasticiser (DEHP) release from medical grade polyvinylchloride (PVC), co-extruded PVC-polyurethane (PIVIPOL)R and an experimentally produced co-extruded PVC-ethylene vinyl acetate (EVA) has been studied when used with manually occluded and self-occluding peristaltic pumps over a six hour pumping period. The shore hardness of the tubings studied were similar but the luminal coating thickness differed (0.2 mm polyurethane, 0.99 mm EVA). The pattern of particle release was similar for all materials on the pump type used with the majority of particles released being less than 5 microns in diameter. The number of particles greater than 5 microns released was independent of the tubing material but depended on the pump type. Particle release with self-occluding pumps was significantly higher (p<0.001) than for the manually occluded pump. Scanning electron microscopy indicated that the particles released originate from the repeated compression and flexing of the insert during pumping which leads to material structural failure. The higher release observed in the case of self-occluding pumps is suggestive of over-occlusion by the springs utilised in the pump. DEHP release (ppm) over a six hour period while perfused at 300 ml/min was significantly reduced for co-extruded tubing (0.56 ± 0.05 mg (PVC-polyurethane) and 0.12 ± 0.04 mg (PVC-EVA) compared with PVC (0.74 ± 0.05 mg).

[1]  M. Marinovich,et al.  Leachability of a new plasticizer tri-(2-ethylhexyl)-trimellitate from haemodialysis tubing. , 1988, The International journal of artificial organs.

[2]  A. Williams,et al.  Silicone-induced hypercalcaemia in haemodialysis patients. , 1987, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[3]  L. Nässberger,et al.  Exposure of patients to phthalates from polyvinyl chloride tubes and bags during dialysis. , 1987, Nephron.

[4]  L. Ljunggren Plasticizer migration from blood lines in hemodialysis. , 1984, Artificial organs.

[5]  E. Ritz,et al.  Reduction of silicone particle release during haemodialysis. , 1985, Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress.

[6]  E. Ritz,et al.  Evidence for macrophage activation in dialysis patients exposed to silicone filing. , 1985, Nephron.

[7]  M. Jacobson,et al.  Hepatic effects of the leaching of phthalate ester plasticizer and silicon. , 1983, Contributions to nephrology.

[8]  S. Kevy,et al.  Hepatic effects of a phthalate ester plasticizer leached from poly(vinyl chloride) blood bags following transfusion. , 1982, Environmental health perspectives.

[9]  W. Lougheed,et al.  AVOIDING SILICONE CELL INCLUSIONS FROM PERISTALTIC PUMPS , 1982, The Lancet.

[10]  A. Leong,et al.  Spallation and migration of silicone from blood-pump tubing in patients on hemodialysis. , 1982, The New England journal of medicine.

[11]  E. Ritz,et al.  Silicone-induced splenomegaly: treatment of pancytopenia by splenectomy in a patient on hemodialysis. , 1981, The New England journal of medicine.

[12]  Harmon We,et al.  The need for a new plasticizer for polyvinyl chloride medical devices. , 1981 .

[13]  S. Kevy,et al.  The need for a new plasticizer for polyvinyl chloride medical devices. , 1981, Transactions - American Society for Artificial Internal Organs.

[14]  R. Grand,et al.  Effects of a plasticizer leached from polyvinyl chloride on the subhuman primate: a consequence of chronic transfusion therapy. , 1977, The Journal of laboratory and clinical medicine.

[15]  R. Tatsukawa,et al.  Migration of plasticiser from haemodialysis blood tubing. , 1976, Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association.

[16]  E. S. Barrow,et al.  Letter: Von Wollebrand's disease. , 1974, Lancet.