Micronanoplastic exposure due to cardiopulmonary bypass in children: A prospective observational study.
Level 4 - case-series / case-control
Prospective single-arm pre-post observational study without a control group
PubMed 40010211 · doi:10.1016/j.jhazmat.2025.137732
What was done
Blood samples were collected before and after cardiopulmonary bypass (CPB) in 22 pediatric patients undergoing congenital heart disease repair. Blood was analyzed for micronanoplastics (MNPs) using pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) and laser direct infrared spectroscopy (LDIR) combined with scanning electron microscopy.
What was found
Py-GC/MS showed a statistically significant increase in total MNPs after CPB (p < 0.0001). Specific polymers with significant post-CPB increases included polypropylene (p < 0.0001), polyvinyl chloride (p < 0.0001), polyamide 6 (p = 0.027), polyethylene (p = 0.038), and polystyrene (p = 0.046). CPB duration correlated positively with MNP exposure (r = 0.43, p = 0.047). Higher MNP exposure correlated with increases in white blood cells (r = 0.52, p = 0.013) and neutrophils (r = 0.46, p = 0.029). LDIR analysis confirmed significantly higher post-CPB particle counts versus baseline (p = 0.015). Absolute mass concentrations and particle counts were not reported in the abstract.
Why it matters
This study provides direct human evidence that plastic circuits used in pediatric cardiopulmonary bypass shed micro- and nanoplastics into patient circulation during surgery. It identifies a direct iatrogenic route of internal plastic exposure in children.
Limits
The study is limited by a very small sample size (n = 22) and an uncontrolled, single-cohort pre-post design. The abstract does not provide absolute quantification values or evaluate downstream clinical endpoints or long-term toxicological outcomes.
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