Carbon dioxide insufflation in open-chamber cardiac surgery: A double-blind, randomized clinical trial of neurocognitive effects

Abstract

Carbon dioxide pericardial insufflation in open-chamber cardiac surgery does not affect postoperative neurocognitive decline. The most important factor is atheromatous vascular disease.

Efficacy of Carbon Dioxide Insufflation for Cerebral and Cardiac Protection During Open Heart Surgery: A Systematic Review and Meta‐Analysis

“…In addition, the elimination time of air was significantly shorter in the treatment group . The theory that carbon dioxide field flooding can eliminate air in the wound with efficiency has also been supported by other studies . As different size of embolus and local flow , only a fraction of intracardiac or intra‐aortic emboli will reach the local circulation , but they are positively correlated.…”

“…We identified a total of 335 citations through our search strategy. After the screen process, four articles were identified and fulfilled inclusion criteria . Details of study selection are shown in Fig.…”

“…Three studies provided data on neurological complications , one of the three studies offered sorted cerebral events data , and thus we amalgamated them as total neurological complications. The overall pooled RR for neurological complications was 1.59, 95% CI = [0.57, 4.46], and the z ‐score for overall effect was 0.89 ( P = 0.37).…”

“…Three studies provided data on all‐cause mortality ; none of these studies reported a statistically significant difference in all‐cause mortality between the CDI group and control group. The overall pooled RR for all‐cause mortality was 0.5, 95% CI = [0.16, 1.64], and the z ‐score for overall effect was 1.14 ( P = 0.25).…”

“…The protection for myocardium and cerebrum of CDI has been reported since 1967 in open heart surgery . Although there are also some researchers opposed to CDI for the incompetence of organ protection, they suppose that an insufficient de‐airing was not the major source of gaseous emboli . What is more, someone reported that CDI caused hypercarbia .…”