Heating and humidifying of carbon dioxide during p

Authors: S S Davis D J Mikami M Newlin B J Needleman M S Barrett R Fries T Larson J Dundon M I Goldblatt W S Melvin

Publish Date: 2005/12/07

Volume: 20, Issue: 1, Pages: 153-158

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Abstract

Carbon dioxide CO2 pneumoperitoneum usually is created by a compressed gas source This exposes the patient to cool dry gas delivered at room temperature 21°C with 0 relative humidity Various delivery methods are available for humidifying and heating CO2 gas This study was designed to determine the effects of heating and humidifying gas for the intraabdominal environmentFor this study 44 patients undergoing laparoscopic RouxenY gastric bypass were randomly assigned to one of four arms in a prospective randomized singleblinded fashion raw CO2 group 1 heated CO2 group 2 humidified CO2 group 3 and heated and humidified CO2 group 4 A commercially available CO2 heater–humidifier was used Core temperatures intraabdominal humidity perioperative data and postoperative outcomes were monitored Peritoneal biopsies were taken in each group at the beginning and end of the case Biopsies were subjected staining protocols designed to identify structural damage and macrophage activity Postoperative narcotic use pain scale scores recovery room time and length of hospital stay were recorded Oneway analysis of variance ANOVA and the nonparametric Kruskal–Wallis test were used to compare the groupsDemographics volume of CO2 used intraabdominal humidity bladder temperatures lens fogging and operative times were not significantly different between the groups Core temperatures were stable and intraabdominal humidity measurements approached 100 for all the patients over the entire procedure Total narcotic dosage and pain scale scores were not statistically different Recovery room times and length of hospital stay were similar in all the groups Only one biopsy in the heated–humidified group showed an increase in macrophage activityThe intraabdominal environment in terms of temperature and humidity was similar in all the groups There was no significant difference in the intraoperative body temperatures or the postoperative variable measured No histologic changes were identified Heating or humidifying of CO2 is not justified for patients undergoing laparoscopic bariatric surgery

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