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World Journal of Surgery

Published in:

01-11-2012

Intraoperative Local Insufflation of Warmed Humidified CO₂ Increases Open Wound and Core Temperatures: A Randomized Clinical Trial

Authors: Joana M. K. Frey, Martin Janson, Monika Svanfeldt, Peter K. Svenarud, Jan A. van der Linden

Published in: World Journal of Surgery | Issue 11/2012

Abstract

Background

The open surgical wound is exposed to cold dry ambient air, resulting in substantial heat loss through radiation, evaporation, and convection. At the same time, anesthesia decreases the patient’s core temperature. Despite preventive measures, mild intraoperative hypothermia has been associated with postoperative morbidity. We hypothesized that local insufflation of warmed humidified carbon dioxide (CO₂) would maintain wound and core temperature.

Methods

Eighty patients undergoing open colon surgery were randomized to standard warming measures, or to additional local wound insufflation of warmed (30 °C) humidified (93 % rH) CO₂ via a gas diffuser. Surface temperature of the open abdominal wound was measured with a heat-sensitive infrared camera, and core temperature was measured with an ear thermometer.

Results

Mean operative time was 219 ± 104 and 205 ± 85 min in the CO₂ group and the control group, respectively (p = 0.550). Clinical variables did not differ significantly between the groups. The median wound area and wound edge temperatures were 1.2 °C (p < 0.001) and 1.0 °C (p = 0.002) higher in the CO₂ group, respectively, than in the control group. The mean core temperature after intubation was the same (35.9 °C) in both groups, but at end of surgery core temperature in the two groups differed, with a mean of 36.2 ± 0.5 °C in the CO₂ group and a mean of 35.8 ± 0.5 °C in the control group (p = 0.003).

Conclusions

Insufflation of warmed, humidified CO₂ in an open surgical wound cavity prevents intraoperative decrease in surgical wound temperature as well as core temperature.

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Title: Intraoperative Local Insufflation of Warmed Humidified CO2 Increases Open Wound and Core Temperatures: A Randomized Clinical Trial
Authors: Joana M. K. Frey
Martin Janson
Monika Svanfeldt
Peter K. Svenarud
Jan A. van der Linden
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 11/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1735-5

At a glance: The STEP trials

Springer Medicine

Intraoperative Local Insufflation of Warmed Humidified CO₂ Increases Open Wound and Core Temperatures: A Randomized Clinical Trial

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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