Poly(vinyl chloride) (PVC) is one of the most important polymeric materials available today and is used to manufacture many items, ranging from packaging and toys to healthcare devices. PVC is per se a rigid material but it is made softer by compounding with plasticizers, particularly phthalate esters such as di-(2-ethylhexyl) phthalate (DEHP). In flexible plasticizer PVC (P-PVC), phthalates are not chemically bound to PVC and they are released into the external environment. In particular, prolonged contact of P-PVC based medical devices with body fluids or tissues has been shown to be associated with severe health risks. Major concerns regarding the safety of P-PVC in medical plastic items have been raised, and several alternatives to phthalates and to P-PVC itself as well as chemical/physical treatments of P-PVC to reduce DEHP migration have been proposed. This review outlines recent scientific approaches for preventing DEHP contamination of humans by P-PVC medical devices, highlighting the impact of the proposed alternative materials on human health and strategies for implementing them

Polymeric materials play a key role in the production of medical and clinical devices thanks to their special features such as flexibility, easy processing and good price/performance ratio. Among the different polymeric matrixes, one of the most used is Poly(vinyl chloride) (PVC). At room temperature PVC is hard and brittle, thus great amounts (40-50%) of phthalate esters that act as plasticizers are added to the polymer to make it flexible and appropriate for medical use. Di-(2-ethylhexyl)-phthalate (DEHP) is the most widely used plasticizer in PVC medical devices. However, DEHP is not chemically bound to PVC and migrates from medical devices with time and use. The potential for DEHP to produce adverse effects in humans has been the subject of considerable discussion and debate in the scientific community. In particular, newborns in the new environment have to be considered at particularly increased risk, because of their small body size and the multiple medical device-related to the DEHP exposure. The major factors determining the degree to which DEHP migrates from medical devices are temperature, amount of DEHP in the device, storage time, shaking of the device while in contact with the medical solutions and degree of PVC degradation.

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Bioerodible polymers displaying both stealth and targeting properties for the preparation of nanosystems for targeted and controlled delivery of fibrinolytic drugs to the thrombus were prepared by straightforward synthetic routes and characterized. Poly[(maleic anhydride)-alt-(butylvinyl ether)]s were synthesized in the presence of dodecyl mercaptan as chain transfer agent allowing for the preparation of copolymers with tunable molecular weight. 2-Methoxyethanol hemiesters containing antiopsonizing molecules of poly(ethylene glycol) were prepared and further biofunctionalized with a Fab fragment by a two-step reaction. In vitro biocompatibility investigation of the prepared materials supported their suitability for biomedical applications.

Background: Polyvinylchloride (PVC) is often adopted for making medical devices. Objective: Testing the hypothesis that materials degradation occurs in PVC endotracheal tubes during infant ventilation, thus releasing the known toxic plasticizer di-(2-ethylhexyl)phthalate (DEHP). Materials and Methods: Endotracheal tubes degradation was assessed by: (1) analysis of color and spectral changes in endotracheal tubes after use in the 400- to 700-nm range and compared to virgin samples. Color changes were expressed as euclidean distances in the Commission International de l’Eclairage Laboratory and Lightness-Chroma-Hue (Munsell’s) color spaces (i.e., ΔE, ΔL, Δa, Δb, ΔC, and ΔH units); (2) DEHP leakage was assessed by thermal characterization by differential scanning calorimetry (DSC) and thermal gravimetric analysis (TGA). Data from used tubes were compared with those from either virgin devices or submitted to artificial aging, including O₂-induced oxidation, washing, UV photodegradation and exposition to acid solutions. Results: Significant color differences of 13.33 ± 0.85 ΔE were evidenced in used endotracheal tubes, as compared to virgin samples (p < 0.0001). Chromatic changes were independent from intubation duration. DSC and TGA analyses showed a loss of DEHP from used tubes, as indicated by increase of the glass transition temperature (Tg) and DEHP weight loss. In vivo application of tubes was associated with an aging process whose effects on the optical and spectral properties were similar to those observed following artificial aging processes. Conclusions: Our findings indicate that significant spectrocolorimetric, DSC and TGA changes occur in endotracheal tubes after application, thus demonstrating for the first time the occurrence of in vivomaterials degradation and DEHP leakage from medical devices worldwide used for neonatal ventilation.