# Plastic Chemicals in Pediatric Cardiopulmonary Bypass: Evaluating Cardiac Toxicity and Investigating Clinical Alternatives

> **NIH NIH F31** · CHILDREN'S RESEARCH INSTITUTE · 2023 · $43,664

## Abstract

Project Summary
Phthalates are a type of plasticizer that are used to make rigid polyvinyl chloride (PVC) plastic flexible. In medical
devices, phthalate levels have been reported to be between 20-80% of a product’s weight depending on the type
of device; however, questions have arisen over their safety. The most common phthalate plasticizer used in PVC
medical devices is di(2-ethylhexyl) phthalate (DEHP). Patients undergoing cardiac surgery involving the use of
a cardiopulmonary bypass (CPB) circuit are exposed to significant levels of DEHP from blood products, circuitry
tubing, bypass cannulas, and endotracheal tubes. Despite the immeasurable benefits of plastics – there is
increasing concern over the potential health risks of phthalate chemical exposures. Accordingly, there is an
urgent need to develop and adopt safer alternatives to be used in pediatric CPB. The proposed research
project will address this need by evaluating the cardiotoxic effects of DEHP on the pediatric heart and
investigating potential mitigation strategies to reduce exposure to toxic phthalate chemicals. Aim 1 will
assess the direct effects of phthalate plasticizers on human pediatric cardiac electrophysiology and contractility.
Aim 2 will determine the efficacy of potential mitigation strategies to reduce phthalate exposure and improve
cardiac outcomes. The latter will include investigating the cardiac safety profile of commercially available DEHP-
free alternatives and the utility of using cell washing to remove phthalate plasticizers from cardiopulmonary
bypass fluids. The results of this proposal will largely be applicable to the fields of cardiology, with the potential
to inform regulatory decision making over the use of phthalate plasticizers in medical device manufacturing. This
is particularly important for medical devices that are used to treat vulnerable neonates and infants undergoing
cardiopulmonary bypass. This application contains a three-year training plan that will further my scientific
development, by building upon the expertise of my Sponsor (Dr. Posnack with expertise in cardiac
electrophysiology and cardiotoxicity) and co-Sponsor (Dr. Ishibashi with experience in preclinical models and
pediatric cardiac surgery). I will also benefit from a broader group of collaborators, who will provide insight into
clinical relevance and experimental techniques. This training proposal will expand my scientific understanding of
pediatric cardiovascular physiology, plasticizer toxicity, and clinically relevant models while supporting my future
goal to lead a translational research laboratory at a top children’s hospital.

## Key facts

- **NIH application ID:** 10677964
- **Project number:** 1F31HL165818-01A1
- **Recipient organization:** CHILDREN'S RESEARCH INSTITUTE
- **Principal Investigator:** Devon Guerrelli
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $43,664
- **Award type:** 1
- **Project period:** 2023-06-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10677964

## Citation

> US National Institutes of Health, RePORTER application 10677964, Plastic Chemicals in Pediatric Cardiopulmonary Bypass: Evaluating Cardiac Toxicity and Investigating Clinical Alternatives (1F31HL165818-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10677964. Licensed CC0.

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