Nav: Home

Attention deficit after kids' critical illness linked to plasticizers in medical tubes

April 01, 2016

Boston, MA-- Children who are often hospitalized in intensive care units are more likely to have attention deficit disorders later, and new research finds a possible culprit: a high level of plastic-softening chemicals called phthalates circulating in the blood. The researchers, who will present their study results Friday at The Endocrine Society's 98th annual meeting in Boston, suggest these chemicals, which are added to indwelling medical devices such as plastic tubes and catheters, seep into the child's bloodstream.

"Phthalates have been banned from children's toys because of their potential toxic and hormone-disrupting effects, but they are still used to soften medical devices," said lead researcher Sören Verstraete, MD, a PhD student at KU (Katholieke Universiteit) Leuven in Leuven, Belgium. "We found a clear match between previously hospitalized children's long-term neurocognitive test results and their individual exposure to the phthalate DEHP during intensive care."

Di(2-ethylhexyl)phthalate, or DEHP, is the most commonly used plastic softener in medical devices made of polyvinyl chloride (PVC). Verstraete called the use of medical devices containing this phthalate "potentially harmful" for the brain development and function of critically ill children.

"Development of alternative plastic softeners for use in indwelling medical devices may be urgently indicated," he said.

Their study included 100 healthy children and 449 children who received treatment in a pediatric intensive care unit (PICU) and underwent neurocognitive testing four years later. Most of the PICU patients were recovering from heart surgery, but some had sustained accidental injuries or had severe infections. The researchers measured blood levels of DEHP metabolites, or byproducts. Initially they performed the blood tests in the healthy children and 228 of the patients while they were in the PICU. Patients had one to 12 medical tubes in the PICU and ranged in age from newborn to 16 years.

The investigators found that DEHP metabolite levels were not detectable in the blood samples of healthy children. However, at admission to the PICU, the critically ill children, already connected to catheters, had levels that Verstraete called "sky-high." Although the DEHP levels decreased rapidly, they remained 18 times higher until discharge from the PICU compared with those of healthy children, he said.

Then the researchers conducted statistical analyses that adjusted for the patients' initial risk factors that could influence the neurocognitive outcome as well as length of stay, complications and treatments in the PICU. A high exposure to DEHP during the PICU stay, according to Verstraete, was strongly associated with attention deficit found at neurocognitive testing four years after discharge. They validated this finding in a different group of 221 PICU patients.

"This phthalate exposure explained half of the attention deficit in former PICU patients," he said, adding that other factors may account for the other half.

The research received funding from the Research Foundation-Flanders (FWO) in Brussels; Methusalem program from the Flemish government in Belgium; European Union's Seventh Framework Programme for Research and Technological Development; and Institute for the Promotion of Innovation by Science and Technology in Flanders (IWT), Brussels. This study appeared in the March issue of the journal Intensive Care Medicine.
-end-
Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world's oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society, which is celebrating its centennial in 2016, has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

The Endocrine Society

Related Intensive Care Articles:

Delirium in critically ill children admitted to intensive care units common and widespread
One out of every four children admitted to intensive care units (ICUs) for critical illness develops delirium, according to an international study led by Weill Cornell Medicine and NewYork-Presbyterian investigators.
Continuous pain is often not assessed during neonatal intensive care
In an analysis of 243 neonatal intensive care units from 18 European countries, investigators found that only 2113 of 6648 (31.8 percent) newborns were assessed for prolonged, continuous pain.
Great differences in the view of withdrawing futile intensive care
The views among physicians and the general public when it comes to deciding whether to withhold or withdraw treatment of terminally ill patients differ greatly.
Primary care physician involvement at end of life associated with less costly, less intensive care
A new study published in the January/February issue of Annals of Family Medicine finds that primary care physician involvement at the end of life is associated with less costly and less intensive end-of-life care.
UNC cardiologist examines training, staffing, research in cardiac intensive care
Jason Katz, M.D., M.H.S., associate professor of medicine at UNC School of Medicine and medical director of the cardiac intensive care unit, was the lead author of a recently published manuscript in the Journal of the American College of Cardiology that examined the early growth and maturation of critical care cardiology, and the challenges and uncertainties that threaten to stymie the growth of this fledgling discipline.
New hope for shock patients in intensive care
Care for critically-ill patients with shock could be improved, it is hoped, after the first successful testing by University of Oxford scientists of a new machine to record oxygen consumption in real time.
Certain red flags indicate an increased need for intensive care among patients with asthma
In patients admitted to the hospital for asthma, illicit drug use and low socioeconomic status were linked with an increased risk of requiring admission to the intensive care unit.
Quiet please in the intensive care unit!
A study presented at Euroanaesthesia 2016 shows that noise levels in the Intensive Care Unit can go well above recommended levels, disturbing both patients and the medical teams that care for them.
Physicians are more likely to use hospice and intensive care at end of life
New research suggests that US physicians are more likely to use hospice and intensive or critical care units in the last months of life than non-physicians.
Patients at high risk for psychiatric symptoms after a stay in the intensive care unit
Results of a multi-institutional national study of nearly 700 people who survived life-threatening illness with a stay in an intensive care unit suggest that a substantial majority of them are at high risk for persistent depression, anxiety and post-traumatic stress disorder -- especially if they are female, young and unemployed.

Related Intensive Care Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Don't Fear Math
Why do many of us hate, even fear math? Why are we convinced we're bad at it? This hour, TED speakers explore the myths we tell ourselves and how changing our approach can unlock the beauty of math. Guests include budgeting specialist Phylecia Jones, mathematician and educator Dan Finkel, math teacher Eddie Woo, educator Masha Gershman, and radio personality and eternal math nerd Adam Spencer.
Now Playing: Science for the People

#517 Life in Plastic, Not Fantastic
Our modern lives run on plastic. It's in the computers and phones we use. It's in our clothing, it wraps our food. It surrounds us every day, and when we throw it out, it's devastating for the environment. This week we air a live show we recorded at the 2019 Advancement of Science meeting in Washington, D.C., where Bethany Brookshire sat down with three plastics researchers - Christina Simkanin, Chelsea Rochman, and Jennifer Provencher - and a live audience to discuss plastics in our oceans. Where they are, where they are going, and what they carry with them. Related links:...