Turning Up the Heat: Does Intra-Operative Warm Humidified CO2 in Open Abdominal Surgery Reduce Time to Return of Bowel Function? A Systematic Review, Meta-Analysis, and Introduction of a Novel RCT Travel Award

Postoperative ileus (POI) substantially impacts recovery post-open abdominal surgery, increasing hospital stays and healthcare costs. Despite Enhanced Recovery After Surgery (ERAS) protocols, POI persists as a notable complication. Warm Humidified Carbon Dioxide Insufflation (WHCI) has demonstrated potential in laparoscopic surgeries by maintaining normothermia and minimizing tissue desiccation, suggesting quicker bowel recovery in open procedures.
Our systematic review and meta-analysis examined WHCI's effectiveness in accelerating bowel function return post-surgery. Preliminary data from existing RCTs indicate WHCI significantly shortens time to first flatus (2.5 vs. 5.0 days, p=0.008) and possibly hastens stool passage (3.7 vs. 5.5 days, p=0.092).
To conclusively determine WHCI's benefits, we are initiating a large-scale, multi-center RCT (ACTRN12625000087459) targeting enhanced patient outcomes and cost reduction in open colorectal surgeries.