Warm and humidified CO2 pneumoperitoneum for Pneumoperitoneum
This study is evaluating whether heated and humidified carbon dioxide gas may reduce inflammation and pain following surgery.
See full descriptionAbout the trial for Pneumoperitoneum
Treatment Groups
This trial involves 2 different treatments. Warm And Humidified CO2 Pneumoperitoneum is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are not being studied for commercial purposes.
Eligibility
This trial is for patients born any sex aged 18 and older. There is one eligibility criterion to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether Warm and humidified CO2 pneumoperitoneum will improve 2 primary outcomes and 12 secondary outcomes in patients with Pneumoperitoneum. Measurement will happen over the course of Day 1.
Patient Q & A Section
Has warm and humidified co2 pneumoperitoneum proven to be more effective than a placebo?
Warm and humidified co2 pneumoperitoneum does not seem to provide a significant effect on postoperative pain compared with control (cool and dry) in open radical retropubic prostatectomy.
How many people get pneumoperitoneum a year in the United States?
In the United States, about 5,200 people per year die from peritonitis induced by intra-abdominal surgery in the outpatient setting. In 10% or more of these cases the death of the person is due to complications or multiple organ failure. As reported by surgeons, the incidence of the pneumoperitoneum requiring surgery in laparoscopic situations is lower when done by a specialist.
What is pneumoperitoneum?
A pneumoperitoneum is an abnormal accumulation of air and fluid in any part of the abdomen. Pneumoperitoneum is associated with penetrating trauma and rupture of the bowel which is frequently seen in blunt abdomen trauma. Pneumomediastinum is accumulation of air and fluid in the mediastinum. These two pneumothoracic lesions are quite similar and a diagnosis of pneumoperitoneum is difficult to differentiate accurately from pneumomediastinum. It is associated with the rupture of organs (including liver, kidney, bowel), penetrating injury and emphysema.
What are common treatments for pneumoperitoneum?
The incidence of pneumoperitoneum, regardless of cause, is not uncommon. Most cases are observed as subacute pneumoperitoneum. Rarely operative intervention may be necessary; however, most cases do not require any treatment.
What are the signs of pneumoperitoneum?
Pneumoretroperitoneum may present with a sudden onset of intense lower back pain, nausea, vomiting, and a rapidly raised erythrocyte sedimentation rate. Pneumoretroperitoneum is the least recognized yet most common cause of laparotomies in the first 2 hours after a pelvic surgical procedure and causes significant morbidity and mortality. Pneumoperitoneum usually does not affect the course of the patient other than by complicating the procedure and increasing morbidity and mortality.
Can pneumoperitoneum be cured?
Results from a recent paper in a large academic referral center shows that pneumoperitoneum must be evaluated and treated before it evolves into severe complications such as empyema or acute cholecystitis or even infection. Appropriate and prompt use of antimicrobials and surgical technique can prevent severe complication to allow for rapid recovery.
What causes pneumoperitoneum?
Most pneumoperitoneum from bowel perforation is not caused by bowel disease but by a pathogenic condition of the peritoneal cavity. Other causes include intraabdominal surgery such as gynecological procedures and diverticulitis.
What is warm and humidified co2 pneumoperitoneum?
Compared to HFCO2 the warm and humidified CO2 pneumoperitoneum does not significantly improve perioperative pain scores, ventilation times, ventilation costs, or length of stay. However, the warm and humidified CO2 pneumoperitoneum results in a slower return of to normal bowel function and a decrease in the use of narcotic.
Is warm and humidified co2 pneumoperitoneum typically used in combination with any other treatments?
Treating PSCI using Warm and Humidified co2 Pneumoperitoneum in combination with other treatments is not usually employed but it is an important and well-known alternative to keep the patients comfortable.
How does warm and humidified co2 pneumoperitoneum work?
During laparoscopic surgery in an atmosphere with a high humidity and warm and humidified CO2 pneumoperitoneum, the effects of aqueous humor and the intraperitoneal gas environment on intraoperative blood clot formation are less marked and postoperative drainage of intraabdominal fluid is better compared to a conventional, ambient air atmosphere laparoscopy. Results from a recent clinical trial, in the authors' opinion, show that the effects of a humidified CO2 pneumoperitoneum should be thoroughly evaluated prior to its application in routine operations.
What is the primary cause of pneumoperitoneum?
There are different primary causes of pneumoperitoneum, with abdominal pathology and surgery in the emergency setting associated with the majority of these cases. Pneumoperitoneum in the outpatient clinic most often occurs as a complication of other gastrointestinal surgery. The finding of pneumoperitoneum or peritonitis on CT scan in the emergency department should prompt the clinician to undertake an exploratory laparotomy. Primary surgical intervention is therefore required for the treatment of the most severe complication of bowel injury. The majority of patients can be managed conservatively without operative intervention with or without antibiotics.
Does pneumoperitoneum run in families?
The prevalence of intracranial and pneumothoracic pathology increases with increasing pneumoperitoneum (PP) duration. Further studies might be useful to identify clinical and genetic risk factors for intracranial or penetrating pneumothoraces.