Effect of temperature of insufflated CO₂ during and after prolonged laparoscopic surgery

Abstract

Background: Pneumoperitoneum with room temperature carbon dioxide (CO₂) has been shown to decrease core temperature and urine output.

Methods: The effect of 37°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.