Warmed, humidified CO<sub>2</sub> insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta‐analysis

Dean, Meara; Ramsay, Robert G.; Heriot, Alexander G.; Mackay, John; Hiscock, Richard; Lynch, A. C.

doi:10.1111/ases.12350

Cited by 36 publications

(35 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Especially during more protracted laparoscopic operations, additional warming and humidification of the insufflation gas can lead to better maintenance of body temperature and avoidance of hypothermia in the second half of the operation and should therefore be used in addition. The authors of a recently published review also come to this conclusion 20 .…”

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Prevention of Intraoperative Hypothermia in Laparoscopy by the Use of Body-Temperature and Humidified CO2: a Pilot Study

Wittenborn

Clausen

Zeppernick

et al. 2019

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Introduction Hypothermia is defined as a decrease in body core temperature to below 36 °C. If intraoperative heat-preserving measures are omitted, a patientʼs temperature will fall by 1 – 2 °C. Even mild forms of intraoperative hypothermia can lead to a marked increase in morbidity and mortality. The temperature of the insufflation gas is usually disregarded in the treatment and prevention of hypothermia. This study was conducted to investigate the effect of body-temperature and humidified CO2 on the intraoperative temperature profile and avoidance of hypothermia in laparoscopic surgery. Material and Methods In this retrospective, non-randomised case control study, 110 patients whose planned operation lasted at least 60 minutes were identified from 376 patients by means of an algorithm. Dry (20% humidity) CO2 at room temperature was insufflated in 51 patients (control group). 59 patients were insufflated with humidified (98% humidity) CO2 at body temperature (37 °C) (study group). These conditions were achieved with the HumiGard MR860 Surgical Humidification System (Fisher & Paykel Healthcare Limited, Auckland, New Zealand). The intraoperative temperature profile was evaluated by measurements every 10 minutes. Statistical analysis was performed with IBM® SPSS® Statistics 23.0.0. Results The intraoperative temperature in the control group fell steadily, while a continuous rise in temperature was observed in the study group. Warming was demonstrated in the study group with a start-end temperature difference of 0.09 °C, which differed significantly from the control group, in which it was − 0.09 °C (p = 0.011). The middle-end difference of 0.11 °C showed even higher significance in favour of the warmed gas (p = 0.003). The rate of hypothermia at the start of the operation fell from 50 to 36% in the study group and increased from 36 to 42% in the control group. Conclusion These results show that the use of body-temperature and humidified insufflation gas for laparoscopy can help to prevent intraoperative hypothermia.

show abstract

Section: Discussionmentioning

confidence: 86%

“…Operationshälfte führen und sollte daher zusätzlich verwendet werden. Zu diesem Schluss kommen die Autoren eines kürzlich publizierten Reviews 20 .…”

Section: Diskussionunclassified

Prevention of Intraoperative Hypothermia in Laparoscopy by the Use of Body-Temperature and Humidified CO2: a Pilot Study

Wittenborn

Clausen

Zeppernick

et al. 2019

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

show abstract

“…To investigate the efficiency of gas coolants, the above tests were repeated for internal cooling mode with CO 2 gas. CO 2 was selected from among the applicable gas coolants for this study as this gas does not have any biocompatibility problem or infection risk according to previous studies and is suitable for using as coolant during bone drilling [18, 33, 34]. The use of CO 2 is also very common in medicine, e.g.…”

Section: Methodsmentioning

confidence: 99%

The effect of spatial distances between holes and time delays between bone drillings based on examination of heat accumulation and risk of bone thermal necrosis

Gholampour

Deh

2019

BioMed Eng OnLine

View full text Add to dashboard Cite

Background and objective This study was designed to investigate heat accumulation and bone thermal necrosis for various distances between holes and time delays between drillings. Methods The tests were performed at three distances (6, 12, 16 mm) and three time delays: 0, 5 and 10 s. To examine the efficiency of coolants, CO 2 coolant was also tested in addition to two common cooling modes in bone drilling. Results The main results were the trend of temperature–time graph, maximum temperature at drilling site, temperature distribution on the surface of drilling site, temperature durability and returning time. The effect of lateral drillings on the initial hole was notable in drilling at a distance of 6 mm without cooling. This effect did not disappear even by increasing the time delay up to 10 s. The results obtained for drilling with normal saline coolant were not sufficiently acceptable due to the manual and non-uniform cooling process as well as the relative obstruction of the chips exit path. Generally, drillings with two common cooling modes, even when the distances between holes and time delays between drillings were controlled, did not yield all favorable conditions for preventing bone thermal necrosis. Conclusion Bone drilling using CO 2 coolant eliminates the risk of bone thermal necrosis completely even in cases that the distances between holes in plates or implants are 6 mm and there is no time delay between drillings. These results can be especially useful in emergency orthopedic surgeries and for designing the location of screw holes in implants and plates.

show abstract

“…Some studies reported that warmed humidified CO 2 insufflation in adult laparoscopic surgery could reduce pain and improve CBT. [12–15,28] Few studies on this issue in the pediatric population yielded both positive and negative conclusions in relatively minor and nonprolonged laparoscopic surgeries. [29,30]…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of warmed humidified carbon dioxide insufflation in infants undergoing major laparoscopic surgery

Meng-Meng¹,

Xu²,

Xiao-Hong³

2019

Medicine

View full text Add to dashboard Cite

Purpose: Some studies have reported that warmed humidified carbon dioxide (CO 2 ) insufflation in adult laparoscopic surgery could reduce pain and improve the core body temperature (CBT). However, similar studies are lacking in infants. Thus, this study aimed to investigate the clinical effects of warmed, humidified CO 2 insufflation in pediatric patients undergoing major laparoscopic surgeries. Methods: From January 2015 to December 2017, infants who underwent major laparoscopic surgeries in Ningbo Women and Children's Hospital were randomized to Group A (standard CO 2 insufflation) or Group B (warmed humidified CO 2 insufflation, 35°C, 95% relative humidity). Change in CBT at the end of surgery was the primary outcome. Secondary outcomes included surgery time, intraoperative blood loss, oxygen saturation (SO 2 ), and Face, Legs, Activity, Cry and Consolability (FLACC) scale. These variables were compared between the 2 groups. Results: Sixty-three infants (38 females, 25 males) were included; 30 patients were in Group A and 33 in Group B. The diseases treated with the laparoscopic approach included congenital megacolon, congenital diaphragmatic hernia, and intestinal malrotation. No deaths were noted. CBT was significantly higher in Group B at the end of surgery ( P = .021). The occurrence of postoperative shivering ( P = .02), hypothermia ( P = .032), bowel movement ( P = .044), and hospital stay ( P = .038) was significantly different between the 2 groups; Group B had less shivering and hypothermia occurrence after surgery. Moreover, Group B demonstrated a more rapid postoperative recovery of bowel movement and shortened hospital stay than Group A. There was no statistical difference in operative time ( P = .162), intraoperative blood loss ( P = .541), SO 2 ( P = .59), and FLACC scale ( P = .65) between the 2 groups. Conclusion: The use of warmed humidified CO 2 insufflation in infants undergoing major laparoscopic surgery was helpful for maintaining normothermia and was associated with several positive postoperative outcomes, including less shivering and hypothermia, faster recovery of bowel movement, and shortened hospital stay.

show abstract

Warmed, humidified CO₂ insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta‐analysis

Cited by 36 publications

References 46 publications

Prevention of Intraoperative Hypothermia in Laparoscopy by the Use of Body-Temperature and Humidified CO2: a Pilot Study

Prevention of Intraoperative Hypothermia in Laparoscopy by the Use of Body-Temperature and Humidified CO2: a Pilot Study

The effect of spatial distances between holes and time delays between bone drillings based on examination of heat accumulation and risk of bone thermal necrosis

Clinical effects of warmed humidified carbon dioxide insufflation in infants undergoing major laparoscopic surgery

Contact Info

Product

Resources

About

Warmed, humidified CO2 insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta‐analysis

Cited by 36 publications

References 46 publications

Prevention of Intraoperative Hypothermia in Laparoscopy by the Use of Body-Temperature and Humidified CO2: a Pilot Study

Prevention of Intraoperative Hypothermia in Laparoscopy by the Use of Body-Temperature and Humidified CO2: a Pilot Study

The effect of spatial distances between holes and time delays between bone drillings based on examination of heat accumulation and risk of bone thermal necrosis

Clinical effects of warmed humidified carbon dioxide insufflation in infants undergoing major laparoscopic surgery

Contact Info

Product

Resources

About

Warmed, humidified CO₂ insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta‐analysis