Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated: A prospective randomized trial

S. S. Davis, D. J. Mikami, M. Newlin, B. J. Needleman, M. S. Barrett, R. Fries, T. Larson, J. Dundon, M. I. Goldblatt, W. Scott Melvin

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: 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 environment. Methods: For this study, 44 patients undergoing laparoscopic Roux-en-Y gastric bypass were randomly assigned to one of four arms in a prospective, randomized, single-blinded fashion: raw CO 2 (group 1), heated CO2 (group 2), humidified CO 2 (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. One-way analysis of variance (ANOVA) and the nonparametric Kruskal-Wallis test were used to compare the groups. Results: Demographics, 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 snowed an increase in macrophage activity. Conclusions: The 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.

Original languageEnglish (US)
Pages (from-to)153-158
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume20
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

Pneumoperitoneum
Humidity
Carbon Dioxide
Heating
Length of Stay
Gases
Temperature
Recovery Room
Narcotics
Carbon Monoxide
Biopsy
Macrophages
Pain
Bariatric Surgery
Gastric Bypass
Operative Time
Body Temperature
Laparoscopy
Lenses
Analysis of Variance

Keywords

  • Carbon dioxide
  • Heated
  • Humidified
  • Insufflation
  • Laparoscopy

ASJC Scopus subject areas

  • Surgery

Cite this

Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated : A prospective randomized trial. / Davis, S. S.; Mikami, D. J.; Newlin, M.; Needleman, B. J.; Barrett, M. S.; Fries, R.; Larson, T.; Dundon, J.; Goldblatt, M. I.; Melvin, W. Scott.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 20, No. 1, 01.2006, p. 153-158.

Research output: Contribution to journalArticle

Davis, SS, Mikami, DJ, Newlin, M, Needleman, BJ, Barrett, MS, Fries, R, Larson, T, Dundon, J, Goldblatt, MI & Melvin, WS 2006, 'Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated: A prospective randomized trial', Surgical Endoscopy and Other Interventional Techniques, vol. 20, no. 1, pp. 153-158. https://doi.org/10.1007/s00464-005-0271-x
Davis, S. S. ; Mikami, D. J. ; Newlin, M. ; Needleman, B. J. ; Barrett, M. S. ; Fries, R. ; Larson, T. ; Dundon, J. ; Goldblatt, M. I. ; Melvin, W. Scott. / Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated : A prospective randomized trial. In: Surgical Endoscopy and Other Interventional Techniques. 2006 ; Vol. 20, No. 1. pp. 153-158.
@article{c1153eb041f7478790cac9d28c9e64be,
title = "Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated: A prospective randomized trial",
abstract = "Background: 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 environment. Methods: For this study, 44 patients undergoing laparoscopic Roux-en-Y gastric bypass were randomly assigned to one of four arms in a prospective, randomized, single-blinded fashion: raw CO 2 (group 1), heated CO2 (group 2), humidified CO 2 (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. One-way analysis of variance (ANOVA) and the nonparametric Kruskal-Wallis test were used to compare the groups. Results: Demographics, 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 snowed an increase in macrophage activity. Conclusions: The 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.",
keywords = "Carbon dioxide, Heated, Humidified, Insufflation, Laparoscopy",
author = "Davis, {S. S.} and Mikami, {D. J.} and M. Newlin and Needleman, {B. J.} and Barrett, {M. S.} and R. Fries and T. Larson and J. Dundon and Goldblatt, {M. I.} and Melvin, {W. Scott}",
year = "2006",
month = "1",
doi = "10.1007/s00464-005-0271-x",
language = "English (US)",
volume = "20",
pages = "153--158",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated

T2 - A prospective randomized trial

AU - Davis, S. S.

AU - Mikami, D. J.

AU - Newlin, M.

AU - Needleman, B. J.

AU - Barrett, M. S.

AU - Fries, R.

AU - Larson, T.

AU - Dundon, J.

AU - Goldblatt, M. I.

AU - Melvin, W. Scott

PY - 2006/1

Y1 - 2006/1

N2 - Background: 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 environment. Methods: For this study, 44 patients undergoing laparoscopic Roux-en-Y gastric bypass were randomly assigned to one of four arms in a prospective, randomized, single-blinded fashion: raw CO 2 (group 1), heated CO2 (group 2), humidified CO 2 (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. One-way analysis of variance (ANOVA) and the nonparametric Kruskal-Wallis test were used to compare the groups. Results: Demographics, 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 snowed an increase in macrophage activity. Conclusions: The 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.

AB - Background: 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 environment. Methods: For this study, 44 patients undergoing laparoscopic Roux-en-Y gastric bypass were randomly assigned to one of four arms in a prospective, randomized, single-blinded fashion: raw CO 2 (group 1), heated CO2 (group 2), humidified CO 2 (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. One-way analysis of variance (ANOVA) and the nonparametric Kruskal-Wallis test were used to compare the groups. Results: Demographics, 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 snowed an increase in macrophage activity. Conclusions: The 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.

KW - Carbon dioxide

KW - Heated

KW - Humidified

KW - Insufflation

KW - Laparoscopy

UR - http://www.scopus.com/inward/record.url?scp=30744461613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=30744461613&partnerID=8YFLogxK

U2 - 10.1007/s00464-005-0271-x

DO - 10.1007/s00464-005-0271-x

M3 - Article

C2 - 16333546

AN - SCOPUS:30744461613

VL - 20

SP - 153

EP - 158

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

IS - 1

ER -