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Effect of temperature of insufflated CO2 during and after prolonged laparoscopic surgery
M Bäcklund1, I Kellokumpu, T Scheinin
1Department of Anaesthesia, Fourth Department of Surgery, Helsinki University Hospital, University of Helsinki, Kasarmikatu 11-13, 00130 Helsinki, Finland.
Background:
Pneumoperitoneum with room temperature carbon dioxide (CO2) has been shown to decrease core temperature and urine output.
Methods:
The effect of 37 degrees C (warm) and room temperature (cool) CO2 pneumoperitoneum on core temperature, urine output, and central hemodynamics was compared in 26 randomized patients undergoing prolonged laparoscopic surgery (>90 min).
Results:
The core temperature (p < 0.05) and cardiac index (p < 0.05) were significantly higher after warm than after cool pneumoperitoneum. Urine output was significantly higher during warm (2.3 +/- 1.6 ml/kg/h) than during cool (0.9 +/- 0.7 ml/kg/h) insufflation (p < 0. 05). Two of 13 patients with warm and 11 of 13 patients with cool pneumoperitoneum needed mannitol to maintain adequate diuresis (p < 0.05).
Conclusions:
Warm insufflation probably causes a local vasodilation in the kidneys and may be beneficial to patients with borderline renal function.