title: Efficiency of a gas diffuser and influence of suction in carbon dioxide deairing of a cardiothoracic wound cavity model.
abstract: OBJECTIVE
  In cardiac surgery, insufflation of carbon dioxide is used for deairing of the heart and great vessels. The aim of this study was to assess a new insufflation device for efficient deairing and to study the influence of suction.
  
  
  METHODS
  We measured the content of remaining air at two positions in the cardiothoracic wound model. A new insufflation device, a gas diffuser, was compared with a conventional 0.25-inch tube. Carbon dioxide flow (5 and 10 L/min) and suction (0, 1.5, 10, and 25 L/min) were varied. Suction was studied in combination with the gas diffuser.
  
  
  RESULTS
  With the tube the median air content in the wound model was 19.5% to 51.7% at the studied carbon dioxide flows, whereas with the gas diffuser the median air content was no greater than 1.2% at 5 L/min and no greater than 0.31% at 10 L/min (P <.001). When suction of 1.5 L/min was applied, the median air content in the model remained low (<or =1.0%) at both carbon dioxide flows. With suction of 10 L/min the median air content was still low (<or =0.50%) at a simultaneous carbon dioxide flow of 10 L/min. Conversely, suction of 25 L/min caused a marked increase in air content at carbon dioxide flows of both 5 and 10 L/min (P <.001).
  
  
  CONCLUSIONS
  This study demonstrated that the most efficient deairing (<or =1% remaining air) in a cardiothoracic wound model was provided by a gas diffuser at a carbon dioxide flow of 10 L/min. A conventional 0.25-inch tube failed to do so (19.5%-51.7% remaining air). Additional suction deteriorated air displacement with the gas diffuser when suction exceeded carbon dioxide inflow.
authors.affiliation: Department Cardiothoracic Surgery and Anesthesiology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Svenarud
authors.forename: Mikael
authors.initials: M
authors.lastname: Persson
authors.forename: Jan
authors.initials: J
authors.lastname: Van Der Linden
mesh_terms: D000399:Air Pressure; D002245:Carbon Dioxide; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D004618:Embolism, Air / Q000209:etiology / Q000517:prevention & control*; D006325:Heart Atria / Q000033:anatomy & histology; D006801:Humans; D007327:Insufflation / Q000295:instrumentation*; D008953:Models, Anatomic; D035423:Thoracic Cavity / Q000033:anatomy & histology / Q000502:physiology
chemical_list: D002245:Carbon Dioxide