• Mikael Persson, Peter Svenarud, and Jan van der Linden.
• Department of Cadiothoracic Surgery and Anesthesiology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden. m.persson@labmed.ki.se
• J. Cardiothorac. Vasc. Anesth. 2004 Apr 1; 18 (2): 180-4.

ObjectivesTo compare recently described insufflation devices for efficient carbon dioxide (CO(2)) deairing of the cardiothoracic wound and to determine the importance of their position.DesignExperimental and clinical.SettingA cardiothoracic operating room at a university hospital.ParticipantsA full-size torso with a cardiothoracic wound and 10 patients undergoing cardiac surgery.InterventionsInsufflation of CO(2) into the wound cavity at 2.5, 5, 7.5, and 10 L/min with a multiperforated catheter and a 2.5-mm tube with either a gauze sponge or a gas-diffuser of polyurethane foam at its end. The devices were tested when positioned at the level of the wound opening and 5 cm below and after exposure to fluid.Measurements And Main ResultsDeairing was assessed by measuring the remaining air content at the right atrium. With the multiperforated catheter, the gauze sponge, and the gas-diffuser, the lowest median air content in the torso was 8.4%, 2.5%, and 0.3%, respectively (p < 0.001), when positioned inside the wound cavity. When exposed to fluid, the gauze sponge and the multiperforated catheter immediately became inefficient (70% and 96% air, respectively), whereas the gas-diffuser remained efficient (0.4% air). During surgery, the gas-diffuser provided a median air content of 1.0% at 5 L/min, and 0.7% at 10 L/min.ConclusionsFor efficient deairing, CO(2) has to be delivered from within the wound cavity. The gas-diffuser was the most efficient device. In contrast to a gas-diffuser, a multiperforated catheter or a gauze sponge is unsuitable for CO(2) deairing because they will stop functioning when they get wet in the wound.

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