Surgical Humidification Therapy

Surgical humidification is the delivery of warm, humidified CO₂ in laparoscopic and open surgery.

DURING SURGERY	POST SURGERY	LONG TERM
Reduces the incidence of peri-operative hypothermia^1,2	Improves end of surgery core body temperature^2,3	May reduce adhesion formation^∆,10
May improve local tissue oxygenation^#∆,15	Reduces local peritoneal inflammation⁹	May reduce tumour burden^«∆,11
May improve local tissue perfusion^#∆,16	Reduces SSI^«,1	May reduce tumour metastasis^«∆,11
Deflects particles^§∆,17	Reduces time in recovery^«,14	Reduction in economic costs¹
« in laparoscopic surgery; # in open surgery; ∆ as demonstrated in an animal model; § as demonstrated in a wound model.

About Surgical Humidification

The condition of the CO₂ traditionally used during laparoscopic surgery and the ambient air during open surgery is vastly different to the conditions of the human body, directly drawing heat and moisture from the already compromised patient. Introducing warm, humidified CO₂ provides an environment which reflects the physiologic condition of the peritoneum.

Video: Impact of Laparoscopic Gas

In order to demonstrate the effects of CO₂ gas used in laparoscopic surgery, this brief film shows three eggs exposed to different CO₂gas conditions over a 60 minute period.

Temperature Maintenance

Surgical humidification reduces the incidence of peri-operative hypothermia^1,2 and improves core body temperature at the end of surgery in both laparoscopic³ and open surgery².

Evaporative cooling during surgery

Surgical humidification aims to reduce the effects of cellular desiccation and evaporative heat loss when the body is exposed to cold, dry CO₂ during laparoscopic surgery or ambient air during open surgery.

Consequences of hypothermia include

Sepsis⁴

3 times more likely to get pneumonia, myocardial infarction and ssi

Pneumonia⁴
Myocardial Infarction⁴
SSI⁵

Mortality⁴

Stroke⁴

Standard warming vs surgical humidification in laparoscopic surgery⁶

The thermal images below demonstrate the cooling effects of 2 hours cold, dry CO₂ laparoscopic insufflation compared with warm, humidified insufflation in a porcine model.

Standard warming vs surgical humidification in open surgery

These images illustrate the effects warm, humidified CO₂ has on improving wound temperature in open surgery.

Laparoscopic porcine images courtesy of Matsuda et al., 2002.⁶
Open images Fisher & Paykel Healthcare, 2016.

Maintaining Cellular Morphology

The use of warm humidified CO₂ during laparoscopic and open surgery may reduce morphological mesothelial damage^7,8 and maintain the integrity and function of the peritoneum^∆.

Peritoneal Damage

Peritoneal damage leads to an increased response and the release of pro-inflammatory and pro-angiogenic mediators enhancing implantation of disseminated cancer cells.

Surgical humidification reduces local peritoneal inflammation⁹ and may reduce adhesion formation¹⁰, tumour burden and metastasis^11«^∆.

During laparoscopic surgery, as the cold, dry gas passes over the peritoneal tissue it draws heat and moisture from the body. This results in the shortening and progressive disapperance of microvilli on the mesothelial cells.

Under this stress, the mesothelial cells start to bulge and retract, breaking cell junctions.

Finally, a large number of cells undergo apoptosis and detach from the basement membrane, leaving it exposed¹². This effect has also been observed in open surgery from exposure to ambient air¹³.

Improving Patient Outcomes with Surgical Humidification

Surgical Humidification reduces time in recovery after laparoscopy¹⁴. With increased length of stay, patient outcomes deteriorate. Also, the extra time in hospital is a financial burden for the healthcare system.

F&P Humigard - An overview of how surgical humidification reduces the risk of postoperative complications

HumiGard at the ICENI Centre

Watch this video showing the response from staff after introducing HumiGard™ surgical humidification at a laparoscopic research and education center in Colchester, UK. The ICENI center has completed a retrospective audit on the introduction of HumiGard™ which demonstrates improved temperature maintenance and reduced incidence of Surgical Site infection¹⁷.

Fisher & Paykel Healthcare has provided research funding to the ICENI Centre.

For more information

Download our Surgical Humidification Therapy Brochure

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