M. Backlund et al., EFFECT OF TEMPERATURE OF INSUFFLATED CO2 DURING AND AFTER PROLONGED LAPAROSCOPIC SURGERY, Surgical endoscopy, 12(9), 1998, pp. 1126-1130
Background: Pneumoperitoneum with room temperature carbon dioxide (CO2
) has been shown to decrease core temperature and urine output. Method
s: The effect of 37 degrees C (warm) and room temperature (cool) CO2 p
neumoperitoneum on core temperature, urine output, and central hemodyn
amics was compared in 26 randomized patients undergoing prolonged lapa
roscopic surgery (>90 min). Results: The core temperature (p < 0.05) a
nd cardiac index (p < 0.05) were significantly higher after warm than
after cool pneumoperitoneum. Urine output was significantly higher dur
ing 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 pat
ients 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 wi
th borderline renal function.