The TEMED Gas Diffuser is a single patient use disposable surgical device for the effective insufflation of carbon dioxide (CO₂ ) into an open surgical wound. The TEMED Gas Diffuser is intended for use by cardiovascular surgeons in open heart surgery procedures for the insufflation of carbon dioxide gas into the thoracic cavity to reduce the risk of air embolism which can result in organ damage. It aims to reduce the risk of air embolism by increasing the level of CO₂ in the local atmosphere. Air will enter the heart and great vessels during conventional open-heart surgery and can be difficult to evacuate with current de-airing techniques. Trapped air will be mobilized to the arterial vessels during weaning from cardiopulmonary bypass and may embolize to the brain and other organs. Since air dissolves poorly in blood and tissue, air bubbles will obstruct blood flow and cause tissue hypoxia and injury. Since CO₂ is 25 times more soluble than air in blood and tissue arterial CO₂ emboli will be fewer and also dissolve more quickly; decreasing the risk of organ injury if CO₂ is delivered to the surgical field. The density of CO₂ is 50% higher than air so it will naturally sink to the lowest point. Delivering CO₂ to the surgical field makes it possible to create, and maintain, an atmosphere of > 98% CO₂ within the chest cavity.
Effect of CO2 insufflation on the number and behavior of air microemboli in open-heart surgery: a randomized clinical trial. Svenarud P, Persson M, van der Linden J., Circulation. 2004 Mar 9;109(9):1127-32: “Insufflation of CO2 into the thoracic wound markedly decreases the incidence of microemboli.”
Intraoperative CO2 insufflation can decrease the risk of surgical site infection Persson M, van der Linden J., Med Hypotheses. 2008;71(1):8-13: “The open surgical wound is subjected to airborne bacterial contamination, desiccation, and heat loss that increase the bacterial load, cause superficial necrosis, and impair tissue oxygenation and cellular immune functions, respectively. The hypothesis is that topically applied carbon dioxide in the open surgical wound can be used Intra-operatively to avoid these risks, and thus help to prevent postoperative wound infection.”
Carbon Dioxide field flooding reduces neurologic impairment after open heart surgery Martens S, Neumann K, Sodemann C, Deschka H, Wimmer-Greinecker G, Moritz A. Ann Thorac Surg. 2008 Feb;85(2):543-7: “Shorter P300 peak latencies after surgery indicate less brain damage in patients who underwent heart valve operations with CO2 flooding of the thoracic cavity.”
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