Comment on Bernard et al. Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 2021, 11, 252

Rainer Otter; Angelika Langsch; Patrick Harmon; Scott C. Boito; Jan Mervart; Michael Grass; Nigel J. Sarginson

doi:10.3390/metabo11090596

Comment on Bernard et al. Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 2021, 11, 252

Metabolites ◽

10.3390/metabo11090596 ◽

2021 ◽

Vol 11 (9) ◽

pp. 596

Author(s):

Rainer Otter ◽

Angelika Langsch ◽

Patrick Harmon ◽

Scott C. Boito ◽

Jan Mervart ◽

...

Keyword(s):

Intensive Care ◽

Medical Devices ◽

Care Management ◽

Urinary Metabolites

The recent publication “Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management” by L. Bernard et al. (2021) [...]

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Reply to Otter et al. Comment on “Bernard et al. Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 2021, 11, 252”

Metabolites ◽

10.3390/metabo11090598 ◽

2021 ◽

Vol 11 (9) ◽

pp. 598

Author(s):

Lise Bernard ◽

Yassine Bouattour ◽

Morgane Masse ◽

Benoît Boeuf ◽

Bertrand Decaudin ◽

...

Keyword(s):

Intensive Care ◽

Medical Devices ◽

Care Management ◽

Urinary Metabolites

The comments written by R. Otter et al. [...]

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Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management

Metabolites ◽

10.3390/metabo11040252 ◽

2021 ◽

Vol 11 (4) ◽

pp. 252

Author(s):

Lise Bernard ◽

Yassine Bouattour ◽

Morgane Masse ◽

Benoît Boeuf ◽

Bertrand Decaudin ◽

...

Keyword(s):

Intensive Care ◽

Medical Devices ◽

Neonatal Intensive Care ◽

Care Management ◽

Urinary Metabolites ◽

High Exposure ◽

Effect Level ◽

Route Of Exposure ◽

Respiratory Assistance ◽

Dehp Exposure

Care management of newborns in the neonatal intensive care unit (NICU) requires numerous PVC (PolyVinyl Chloride) medical devices (MD) containing plasticizers that can migrate and contaminate the patient. We measured the magnitude of neonates’ exposure to plasticizers (di-ethylhexylphthalate (DEHP) and alternatives) in relation to urinary concentrations of their metabolites. Plasticizers’ exposure was evaluated (1) by calculating the amounts of plasticizers prone to be released from each MD used for care management, and (2) by measuring the patients’ urinary levels of each plasticizers’ metabolites. 104 neonates were enrolled. They were exposed to di-isononylphthalate (DINP), especially via transfusion and infusion MD, and to DEHP via ECMO (Extra Corporeal Membrane Oxygenation) and respiratory assistance MD. Mean exposure doses exceeded the derived no-effect level of DINP and DEHP by a 10-fold and a 1000-fold factor. No PVC MD were plasticized with di-isononylcyclohexane-1,2-dicarboxylate (DINCH). High urinary concentrations of DEHP metabolites were directly correlated with DEHP exposure through ECMO MD. Urinary concentrations of DINP metabolites in transfused patients were also high. DINCH metabolites were found in urine, suggesting another route of exposure. Neonates in NICU are considerably exposed to plasticizers, with magnitudes varying with the type of MD used. The high exposure to DEHP and DINP leads to a risk of their metabolites’ toxicity.

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Recommendations for Intensive Care Management in Small Animals Following Anaesthesia

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633069 ◽

1992 ◽

Vol 05 (02) ◽

pp. 66-70

Author(s):

Karol Mathews ◽

Doris Dyson

Keyword(s):

Intensive Care ◽

Care Management ◽

Small Animal ◽

Small Animals ◽

Monitoring Equipment ◽

Intensive Care Management ◽

Good Communication

Intensive care management can be provided in a small animal facility by centralisation of emergency and monitoring equipment. Good communication between all personnel involved in the case ensures that staff are prepared for complications that could arise related to recovery from anaesthesia.

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Drug Overdosage in Children

Anaesthesia and Intensive Care ◽

10.1177/0310057x7400200403 ◽

1974 ◽

Vol 2 (4) ◽

pp. 303-309 ◽

Cited By ~ 6

Author(s):

T. C. K. Brown ◽

F. I. Bishop ◽

G. C. Mullins

Keyword(s):

Intensive Care ◽

Respiratory Failure ◽

Emergency Treatment ◽

Care Management ◽

Tricyclic Antidepressants ◽

Conscious State ◽

Circulatory Failure ◽

Intensive Care Management ◽

Drug Overdosage

The epidemiology and prevention of drug overdosage in children is discussed. The emergency treatment of acute drug overdosage is outlined together with aspects of the intensive care management in relation to conscious state, convulsions, respiratory failure, circulatory failure and arrhythmias with some emphasis on tricyclic antidepressants.

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SARS-CoV-2 aerosol generation during respiratory equipment reprocessing

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-00955-2 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Camila Quartim de Moraes Bruna ◽

Caroline Lopes Ciofi-Silva ◽

Anderson Vicente de Paula ◽

Lucy Santos Villas Boas ◽

Noely Evangelista Ferreira ◽

...

Keyword(s):

Intensive Care ◽

Severe Acute Respiratory Syndrome ◽

Intensive Care Units ◽

Medical Devices ◽

Aerosol Generation ◽

Surface Samples ◽

Tertiary Hospitals ◽

Air Sample ◽

Sterile Processing

AbstractAerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices. Air and surface samples were collected from the sterile processing department of two teaching tertiary hospitals during the reprocessing of respiratory equipment used in patients diagnosed with coronavirus disease 2019 and from intensive care units during treatment of these patients. SARS-CoV-2 was detected only in 1 air sample before the beginning of decontamination process. Viable severe acute respiratory syndrome coronavirus 2 RNA was not detected in any sample collected from around symptomatic patients or in sterile processing department samples. The cleaning of respiratory equipment does not cause aerosolization of SARS-CoV-2. We believe that the use of medical masks is sufficient while reprocessing medical devices during the coronavirus disease 2019 pandemic.

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