Guest article from Paul Whaley, Health Care WIthout Harm
Image (c) Stefan Gara
The type of material used in administering intravenous feeding is a risk factor in the development of liver problems in premature infants, a new study has concluded.
The research, published in the journal Pediatrics, found that PVC tubing containing the chemical DEHP substantially increased the chance of developing poor drainage of bile from the liver, known as cholestasis. (1)
Other research has already shown that DEHP leaches out of tubing used for intravenous feeding (2), leading to substantial exposures for patients, and also that intravenous feeding itself is an added risk factor for cholestasis (3).
What is new in this study is the direct comparison between cholestasis incidence in infants treated with PVC and PVC-free tubing systems, which allowed an association between DEHP-containing tubes and cholestasis to be determined.
In this specific study, the use of tubing systems containing DEHP increased the risk for cholestasis by a factor of 5.6. After changing to systems free from DEHP, the incidence of cholestasis dropped from 50% to 18%.
Health Care Without Harm is an international coalition of hospitals and health care systems, medical professionals, community groups, health-affected constituencies, labor unions, environmental and environmental health organizations and religious groups. Its mission is to transform the health care sector worldwide so that it is longer a source of harm to public health and the environment.
This article was first published in Health and Environment, a monthly e-publication about environmental issues and what they mean for health and healthcare.
References:
1. Study: Pediatrics 124:710-716; von Rettberg et al
2. DEHP: J Pharm. 262(1-2):83-91; Kambia K et al
3. Intravenous feeding (TPN): Clin Liver Dis. 12(1):97-110; Guglielmi FW et al
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