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International Journal of Colorectal Disease

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Open Access 01-03-2016 | Original Article

Relation of intraoperative temperature to postoperative mortality in open colon surgery—an analysis of two randomized controlled trials

Authors: J. Frey, M. Holm, M. Janson, M. Egenvall, J. van der Linden

Published in: International Journal of Colorectal Disease | Issue 3/2016

Abstract

Introduction

The open surgical wound is exposed to cold and dry ambient air resulting in heat loss mainly through radiation and convection. This cools the wound and promotes local vasoconstriction and hypoxia. Carbon dioxide (CO₂) and water vapor are greenhouse gases with a warming effect. The aim was to evaluate if warm humidified CO₂ insufflated in surgical wound can affect long-term overall mortality

Methods

This is a retrospective study of two clinical trials, where patients were randomized to warm humidified CO₂ (n = 80) or not (n = 78). All patients underwent elective major open colon surgery. Patients in the treatment group received insufflation of warm humidified CO₂ into the open wound cavity via a gas diffuser to create a local atmosphere of 100 % CO₂. Temperature in the wound cavity was measured with a heat-sensitive infrared camera. Core temperature was measured at the tympanic membrane. Median follow-up was 70.9 months.

Results

A multivariate analysis adjusted for age (p = 0.001) and cancer (p = 0.165) showed that the larger the temperature difference between final core temperature and wound edge temperature, the lower the overall survival rate (p = 0.050). Patients receiving insufflation of warm humidified CO₂ had a tendency to a better overall survival compared with control patients (p = 0.508). End-of-operation wound edge temperature was negatively associated with mortality (OR = 0.80, 95 % CI = 0.68-0.95, p = 0.011), whereas mortality was positively associated with age (10-year increase, OR = 1.78, 95 % CI = 1.37-2.33, p < 0.001) and cancer (OR = 8.1, 95 % CI = 1.95–33.7, p = 0.004).

Conclusions

A small end-of-operation temperature difference between final core and wound edge temperature was positively associated with patient survival in open colon surgery.

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Title: Relation of intraoperative temperature to postoperative mortality in open colon surgery—an analysis of two randomized controlled trials
Authors: J. Frey
M. Holm
M. Janson
M. Egenvall
J. van der Linden
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 3/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2467-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Relation of intraoperative temperature to postoperative mortality in open colon surgery—an analysis of two randomized controlled trials

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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