HCP · Evidenze scientifiche
Base di evidenze scientifiche
Una panoramica strutturata delle principali pubblicazioni scientifiche a supporto dell’insufflazione di CO₂ e dell’erogazione mediante diffusore nella chirurgia cardiaca.
I riassunti riflettono i dati pubblicati. I risultati individuali possono variare. Gli operatori sanitari devono consultare le pubblicazioni originali e la normativa locale. Destinato esclusivamente agli operatori sanitari.
- ¹Svenarud P, Persson M, van der Linden J.Effect of CO₂ insufflation on the number and behavior of air microemboli in open-heart surgery: a randomized clinical trial.Circulation. 2004;109(9):1127–1132. · doi:10.1161/01.CIR.0000118501.44474.83▸Supportive relevance: RCT demonstrating that diffuser-based CO₂ insufflation significantly reduces both the number (~4×) and size of air microemboli and accelerates their clearance.
- ²Persson M, van der Linden J.De-airing of a cardiothoracic wound cavity model with carbon dioxide: theory and comparison of a gas diffuser with conventional tubes.J Cardiothorac Vasc Anesth. 2003;17(3):329–335.▸Supportive relevance: Gas diffusers achieve near-complete CO₂ atmospheres, while conventional tubes allow significant air mixing.
- ³Kokhanenko P, Papotti G, Cater JE, Lynch AC, van der Linden JA, Spence CJT.Carbon dioxide insufflation deflects airborne particles from an open surgical wound model.J Hosp Infect. 2017;95(1):112–117. · doi:10.1016/j.jhin.2016.11.006▸Supportive relevance: Up to ~1000× reduction in airborne particle contamination due to stable CO₂ barrier formation.
- ⁴Svenarud P, Persson M, van der Linden J.Efficiency of a gas diffuser and influence of suction in carbon dioxide deairing of a cardiothoracic wound cavity model.J Thorac Cardiovasc Surg. 2003;125(5):1043–1049. · doi:10.1067/mtc.2003.50▸Supportive relevance: Diffuser-based systems maintain effective CO₂ concentrations even under suction and surgical disturbance.
- Svenarud P, Persson M, van der Linden J.Effect of CO₂ insufflation on the number and behavior of air microemboli in open-heart surgery: a randomized clinical trial.Circulation. 2004;109(9):1127–1132. · doi:10.1161/01.CIR.0000118501.44474.83▸Supportive relevance: RCT demonstrating that diffuser-based CO₂ insufflation significantly reduces both the number (~4×) and size of air microemboli and accelerates their clearance.
- Al-Rashidi F, Landenhed M, Blomquist S, Höglund P, Karlsson PA, Pierre L, Koul B.Comparison of the effectiveness and safety of a new de-airing technique with a standardized carbon dioxide insufflation technique in open left heart surgery: a randomized clinical trial.J Thorac Cardiovasc Surg. 2011;141(5):1128–1133.▸Supportive relevance: Comparison of two de-airing techniques (one through a CO2 diffuser and one technique that involves complete lung collapse) at Lund university hospital
- Al-Rashidi F, Blomquist S, Höglund P, Meurling C, Roijer A, Koul B.A new de-airing technique that reduces systemic microemboli during open surgery: a prospective controlled study.J Thorac Cardiovasc Surg. 2009;138(1):157–162.▸Supportive relevance: Clinical evidence that improved de-airing strategies significantly reduce systemic microemboli.
- Chaudhuri K, Storey E, Lee GA, et al.Carbon dioxide insufflation in open-chamber cardiac surgery: a double-blind, randomized clinical trial of neurocognitive effects.J Thorac Cardiovasc Surg. 2012;144(3):646–653.e1.▸Supportive relevance: Significantly faster and more complete clearance of intracardiac air with CO₂ insufflation.
- Nyman J, Svenarud P, van der Linden J.Carbon dioxide de-airing in minimal invasive cardiac surgery, a new effective device.J Cardiothorac Surg. 2019;14(1):12.▸Supportive relevance: Diffuser-based CO₂ delivery achieves near-complete CO₂ environments (<1% residual air) even in MICS.
- Nyman J, Rundby C, Svenarud P, van der Linden J.Does CO₂ flushing of the empty CPB circuit decrease the number of gaseous emboli in the prime?Perfusion. 2009;24(4):249–255.▸Supportive relevance: CO₂ flushing reduces gaseous emboli outside the surgical field, supporting the broader prevention concept.
- Weltert LP, Audisio K, La Torre M, et al.CO₂ delivery techniques in mini-sternotomy surgery and neurological events: a multicentric study.BMC Cardiovasc Disord. 2024;24:582. · doi:10.1186/s12872-024-04237-8▸Supportive relevance: In a prospective multicentre study of 275 patients undergoing aortic valve replacement via J mini-sternotomy, CO₂ delivered through a dedicated sponge diffuser was associated with fewer postoperative neurological events than no CO₂ and shorter mechanical ventilation than cannula-based or no-CO₂ delivery.