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HCP · Wetenschappelijk bewijs
Wetenschappelijke onderbouwing
Een gestructureerd overzicht van de belangrijkste wetenschappelijke publicaties ter ondersteuning van CO₂-insufflatie en toevoer via diffusor bij hartchirurgie.
De samenvattingen geven de gepubliceerde gegevens weer. Individuele resultaten kunnen variëren. Zorgprofessionals dienen de oorspronkelijke publicaties en de lokale regelgeving te raadplegen. Uitsluitend bestemd voor zorgprofessionals.
- ¹Svenarud P, Persson M, van der Linden J.Effect of carbon dioxide 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, Svenarud P, 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, et al.Carbon dioxide insufflation deflects airborne particles from an open surgical wound model.J Hosp Infect. 2016;94:297–304. · doi:10.1016/j.jhin.2016.07.006▸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 de-airing 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 carbon dioxide 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, et al.Comparison of the effectiveness and safety of a new de-airing technique with standardized carbon dioxide insufflation in open left heart surgery: a randomized clinical trial.J Thorac Cardiovasc Surg. 2011;141(5):1128–1133.▸Supportive relevance: Optimized CO₂-based de-airing significantly reduces embolic load and improves procedural efficiency.
- 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. 2010;139(6):1579–1585.▸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 randomized clinical trial.J Thorac Cardiovasc Surg. 2012;144(3):646–653.▸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 minimally invasive cardiac surgery: a new effective device.J Cardiothorac Surg. 2019;14:12.▸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 carbon dioxide 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.