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

Pneumoperitoneum with room temperature carbon dioxide (CO2) has been shown to decrease core temperature and urine output.The effect of 37 degrees 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).The core temperature (p0.05) and cardiac index (p0.05) 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 (p0. 05). Two of 13 patients with warm and 11 of 13 patients with cool pneumoperitoneum needed mannitol to maintain adequate diuresis (p0.05).Warm insufflation probably causes a local vasodilation in the kidneys and may be beneficial to patients with borderline renal function.