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Hypothermia induced by laparoscopic insufflation. A randomized study in a pig model
J R Bessell1, A Karatassas, J R Patterson
1Department of Surgery, University of Adelaide, Queen Elizabeth Hospital, Australia.
Surgical Endoscopy
|July 1, 1995
Summary
High-flow carbon dioxide insufflation during laparoscopic surgery causes significant core temperature drops in pigs. Warming the gas offers no protection; humidification is key to minimizing hypothermia during these procedures.
Area of Science:
- Anesthesiology
- Surgical Physiology
- Veterinary Medicine
Background:
- Postoperative hypothermia is a frequent complication.
- Limited data exist on the impact of laparoscopy on perioperative heat balance.
Purpose of the Study:
- To quantify core temperature changes during prolonged, high-flow CO2 insufflation in laparoscopy.
- To evaluate the effect of insufflated gas temperature and humidification on perioperative heat balance.
Main Methods:
- A randomized, controlled trial involving six pigs, each serving as its own control.
- Three conditions were tested: no gas insufflation, cold CO2 gas, and warmed CO2 gas.
- Core temperature was monitored over a 3-hour period.
Main Results:
- High-flow CO2 insufflation significantly decreased core body temperature.
- Warming the insufflated CO2 gas did not prevent hypothermia.
- The primary cause of heat loss was the latent heat of vaporization required to humidify the gas.
Conclusions:
- Prolonged, high-flow CO2 insufflation in laparoscopy leads to significant hypothermia.
- Humidifying the insufflated gas, rather than just warming it, is crucial for minimizing heat loss.
- Strategies to increase gas humidity should be considered to mitigate perioperative hypothermia.