It is commonly known that stored blood and blood products are heated before transfusion in order to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate content leaching into the blood and blood products and thereby causes greater conversion of di-(2-ethylhexyl) phthalate to mono (2-ethylhexyl) phthalate. However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension transfused via warming. In this study, we aimed to investigate the di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate content in blood following the ES transfusions administered by di-(2-ethylhexyl) phthalate -containing and di-(2-ethylhexyl) phthalate -free infusion sets. The study included 30 patients that were randomly divided into 2 groups with 15 patients each: group I underwent erythrocyte suspension transfusion via di-(2-ethylhexyl) phthalate -containing infusion sets warmed with blood-fluid warmers and group II underwent erythrocyte suspension transfusion via di-(2-ethylhexyl) phthalate-free infusion sets warmed with blood-fluid warmers. Di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate levels were measured both before and after transfusion. Di-(2-ethylhexyl) phthalate-free infusion sets led to no increase in the phthalate content, whereas di-(2-ethylhexyl) phthalate-containing infusion sets significantly increased the di-(2-ethylhexyl) phthalate and mono (2-ethylhexyl) phthalate levels, where the di-(2-ethylhexyl) phthalate level increased almost four times (p=0.001). Di-(2-ethylhexyl) phthalate-containing products lead to toxicity. Therefore, using di-(2-ethylhexyl) phthalate-free products may prevent toxicity in patients undergoing erythrocyte suspension transfusion.
Aim: To investigate the diagnostic value of pulmonary embolism severity index (PESI), Simplified PESI (sPESI), Shock Index (SI), Modified SI (MSI), and Age SI (ASI) scores in predicting 30-day mortality in patients diagnosed with pulmonary thromboembolism (PTE) in the emergency department. Materials and Methods: The retrospective study included 257 patients that presented to the emergency department and underwent contrast-enhanced computed tomography pulmonary angiogram (CTPA) due to the suspicion of PTE and were interpreted as PTE by an experienced radiologist between January 1, 2015 and September 20, 2018.The PESI, sPESI, SI, MSI, and ASI scores were calculated for each patient. Results: On univariate logistic regression analysis, 30-day mortality was found to be significantly associated with age, mode of presentation, SBP, DBP, MAP, heart rate, respiratory rate, O2 saturation, temperature, D-dimer, troponin I, high-sensitivity cardiac troponin (hs-cTn), lactate, and SI, MSI, ASI, PESI, and sPESI scores (p<0.05). PESI had the highest AUC value for the prediction of 30-day mortality among all scoring systems. Conclusion: PESI had the highest diagnostic value in predicting 30-day mortality in the patients diagnosed with PTE in the emergency department, followed by ASI. Our findings regarding ASI may shed light on future studies evaluating critical patient groups.”