Transcutaneous PCO2 monitoring in critically ill patients: update and perspectives

Journal of Thoracic Disease
Arnaud MariFabrice Vallée

Abstract

The physiology of venous and tissue CO2 monitoring has a long and well-established physiological background, leading to the technological development of different tissue capnometric devices, such as transcutaneous capnometry monitoring (TCM). To outline briefly, measuring transcutaneous PCO2 (tcPCO2) depends on at least three main phenomena: (I) the production of CO2 by tissues (VCO2), (II) the removal of CO2 from the tissues by perfusion (wash-out phenomenon), and (III) the reference value of CO2 at tissue inlet represented by arterial CO2 content (approximated by arterial PCO2, or artPCO2). For this reason, there are, at present, roughly two clinical uses for tcPCO2 measurement: a respiratory approach where tcPCO2 is likely to estimate and non-invasively track artPCO2; and a hemodynamic under-estimate use where tcPCO2 can reflect tissue perfusion, summarized by a so-called "tc-art PCO2 gap". Recent research shows that these two uses are not incompatible and could be combined. The spectrum of indications and validation studies in ICUs is summarized in this review to give a survey of the potential applications of TCM in critically ill patients, focusing mainly on its potential (micro)circulatory monitoring contribution. We stro...Continue Reading

Citations

Nov 14, 2020·Anesthesia and Analgesia·Nicole P JuffermansDerek J B Kleinveld
Jul 4, 2020·The European Respiratory Journal·Lukas PerkhoferMartin Müller
Aug 5, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Tobias WertherMichael Wagner
Aug 30, 2021·Current Opinion in Biotechnology·Kenta IitaniGovind Rao

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