TEMED Gas Diffuser

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.‬

Further information

The TEMED gas diffuser will be used by cardiovascular surgeons during open heart surgery procedures for the insufflation of carbon dioxide in to the thoracic cavity to reduce the risk of air embolism.   The tip of the gas diffuser is to be located within the thoracic cavity at a distance of two inches (2”) from the wound surface. A flow regulator will be used to regulate the delivery of CO₂ so that it stays within the required range of 0-10 litres/minute at all times.   The TEMED gas diffuser delivers the medical grade CO₂ from its source to the thoracic cavity. The malleable section of the gas diffuser allows the surgeon to locate the tip precisely where they deem it necessary.
Wound ventilation with carbon dioxide: a simple method to prevent direct airborne contamination during cardiac surgery? Persson M, van der Linden J., J Hosp Infect. 2004 Feb;56(2):131-6: “Intraoperative wound ventilation with CO2 using a gas-diffuser may not only prevent air embolism, but may also significantly reduce the risk of airborne contamination and postoperative wound infection in cardiac surgery.”
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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