umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Endogenous gas formation of carbon dioxide used for wound flooding - an experimental study with implications regarding gas microembolism during cardiopulmonary bypass
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Heart Centre, Cardiothoracic Surgery, Umeå.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Heart Centre, Cardiothoracic Surgery, Umeå.
2014 (English)In: Perfusion, ISSN 0267-6591, E-ISSN 1477-111X, Vol. 29, no 3, 242-248 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Gas microembolisation is an identified risk in cardiac surgery. Flooding the wound with carbon dioxide is a method proposed to reduce this problem. The high solubility of carbon dioxide is beneficial, but may also cause problems. The gas solubility diminishes at warming and endogenous bubbles are formed when cold blood saturated with carbon dioxide is returned by cardiotomy suction.

METHODS: The release of endogenous gas was measured at high resolution in an experimental digital model. A medium (water or blood) was incubated and equilibrated with gas (100% carbon dioxide or air) at a low temperature (10°C or 23°C). The temperature was increased to 37°C and the gas release was measured, at rest and at fluid motion.

RESULTS: The amount of carbon dioxide released at warming was substantial for both water and blood (both p=0.005). The effect was more pronounced when the temperature differential increased (p=0.005). However, blood and water differed in these terms: with water, the release of carbon-dioxide started instantly at warming; with blood, carbon dioxide remained dissolved and was released at fluid motion. When blood was warmed from 10°C to 37°C, the gas release corresponded to 44.4% (40.6/46.5) of the medium volume (median with quartile range).

CONCLUSION: Gas dissolved in a medium becomes released at warming, as confirmed here. Blood exposed to carbon dioxide became heavily oversaturated at warming, with the gas instantly released at fluid motion. The amount of contained gas increased with a higher temperature differential. Our study has relevance to wound flushing, using carbon dioxide, in cardiac surgery. The clinical consequences of these findings remain to be answered.

Place, publisher, year, edition, pages
2014. Vol. 29, no 3, 242-248 p.
Keyword [en]
cardiopulmonary bypass, gas embolization, carbon dioxide, wound flooding, gas solubility, temperature
National Category
Surgery Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-86092DOI: 10.1177/0267659113512358PubMedID: 24225405OAI: oai:DiVA.org:umu-86092DiVA: diva2:697035
Available from: 2014-02-17 Created: 2014-02-17 Last updated: 2017-12-06Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Engström, Karl-Gunnar

Search in DiVA

By author/editor
Lindholm, LenaEngström, Karl-Gunnar
By organisation
Surgery
In the same journal
Perfusion
SurgeryCardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 60 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf