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CARDIOVASCULAR ANESTHESIA

Can Wound Desiccation Be Averted During Cardiac Surgery? An Experimental Study

Division of Medical Engineering, Department of Laboratory Medicine, and Department of Cardiothoracic Surgery & Anesthesiology; Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden

Address correspondence and reprint requests to Mikael Persson, Department of Laboratory Medicine, Karolinska University Hospital, Karolinska Institute, SE-141 86 Stockholm, Sweden and Jan van der Linden, Department of Cardiothoracic Surgery & Anesthesiology, Karolinska University Hospital, Karolinska Institute, SE-141 86 Stockholm, Sweden. Address e-mail to m.persson{at}labmed.ki.se and janvan{at}ki.se.

During cardiac surgery the wound is exposed to desiccation, especially as a result of operating room ventilation and the insufflation of dry carbon dioxide (CO₂) for de-airing. We compared the gas humidity and desiccation rates in an in vitro model of a cardiothoracic wound during these conditions and during insufflation of humidified CO₂. To assess the influence of flow velocity, CO₂ was insufflated at 10 L/min via two devices, a standard open-ended tube and a low-velocity gas diffuser. The treatment arms were compared with a control without insufflation. When insufflated via the open-ended tube the humidity in the model was almost equal to the control, both with dry and humidified CO₂. However, the total desiccation rate was more rapid than the control (P < 0.001), especially in the area exposed to the gas jet where the desiccation rate was three times more rapid (P < 0.001). With the gas diffuser, dry CO₂ caused almost zero humidity and a desiccation rate that was almost equal to the control. Humidified CO₂ increased humidity in comparison with the control (P < 0.001) and decreased the desiccation rate by >90% (P < 0.001). Humidified CO₂ may be used to avert desiccation of the cardiothoracic wound. The humidified gas is effective only when delivered via a low-velocity outlet device.

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