Optimizing CO2 field flooding during sternotomy: In vitro confirmation of the Karolinska studies.

Although CO2 field-flooding was first used during cardiac surgery more than 60 years ago, its efficacy is still disputed. The invisible nature of the gas and the difficulty in determining the "safe" quantity to protect the patient are two of the main obstacles to overcome for its validation. Moreover, CO2 concentration in the chest cavity is highly sensitive to procedural aspects, such suction and hand movements.

Patient tilt improves efficacy of CO field-flooding in minimally invasive cardiac surgery.

Objective: Space limitations during minimally invasive cardiac surgery impede consistent use of CO field-flooding. We compared different gas delivery methods, flow rates and the effect of patient inclination.

Methods: A gastight model of MICS surgery with internal organs and right thoracotomy wound was created from a mannequin and equipped with a CO concentration sensor in the left ventricle.