Transcutaneous O2 and CO2 Monitoring in the Adult

  • William C. Shoemaker
  • Kevin K. Tremper


Transcutaneous gas sensors have become an important real time monitoring technique, but not for the reasons they were originally designed. The original concept was to measure arterial blood gases noninvasively, but by an odd quirk of fate this is possible only in a narrow restrictive sense. Their most important use lies in their capacity to measure a tissue O2 perfusion and CO2 washout in critically ill adults and neonates with circulatory as well as respiratory failure. From the point of view of real time surveillance for early warning of cardiorespiratory compromise, it is advantageous that the sensors measure gases at the skin surface, as the cutaneous circulation is the most sensitive and vulnerable of all organs during incipient circulatory failure.


Cardiac Index Cardiac Decompensation Transcutaneous Oxygen Severe Shock Real Time Surveillance 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    von Gerlack: Uber das Hautatman, Arch.Anat.Physiol. Leipzig, 431–479, 1851.Google Scholar
  2. 2.
    L.A. Shaw, A.C. Weiss, Cutaneous respiration in man, I: Factors affecting the rate of carbon dioxide elimination and oxygen absorption, Am.J.Physio1. 90: 107–118, 1929.Google Scholar
  3. 3.
    J.P. Baumberger, R.B. Goodfried, Determination of aterial oxygen tension in man by equilibration through intact skin, Fed.Proc.Am.Soc.Exp.Biol. 10: 10–11, 1951.Google Scholar
  4. 4.
    G. Rooth, U. Hedstrand, H. Tyden, et al, The validity of the transcutaneous oxygen tension method in adults, Crit. Care. Med. 4: 162, 1976.CrossRefGoogle Scholar
  5. 5.
    L.C. Clark, Jr, Monitor and control of blood tissue oxygen tensions, Trans. Am. Soc. Art. Int. Org. 2: 41, 1956.Google Scholar
  6. 6.
    N.T.S. Evans, and P.F.D. Naylor, The systemic oxygen supply to the surface of human skin. Respir Physiol 3: 21–37, 1967.CrossRefGoogle Scholar
  7. 7.
    A. Huch, R. Huch, D.W. Lubbers, Quantitative polarographische sauerstoff druckmessung aut der lopthaut des neugebovenen, Arch Gynak 207: 443, 1969.CrossRefGoogle Scholar
  8. 8.
    A. Huch, R. Huch, R. Meinzer, et al, Eine schnelle, behizte ptoberflachen elektrode zur kontinuier lichen uberwach ung des P02 beim menschen, Elektrodenaufbau und-eigen schaften, Stuttgart, Proc Medizin-Technik, 1972, p 26.Google Scholar
  9. 9.
    P. Eberhard, K. Hammacher, and W. Mindt, Perkutane messung des sauerstaff partialdruckes, Methodik und Anwendungen, Stuttgart, Proc Medizin-Technik, 1972, p 26.Google Scholar
  10. 10.
    A. Furuse, R.K. Brawley, E. Struve, et al, Skeletal muscle gas tension, indicator of cardiac output and peripheral tissue perfusion, Surgery 74: 214, 1973.Google Scholar
  11. 11.
    P. Littooy, R. Fuchs, T.K. Hunt, et al, Tissue oxygen as a real time measure of oxygen transport, J. Surg. Res. 20: 321, 1976.CrossRefGoogle Scholar
  12. 12.
    J. Niinikoski, Tissue oxygen in hypovolaemic shock, Ann. Clin. Res. 9: 151, 1977.Google Scholar
  13. 13.
    W.C. Shoemaker, E.M. Montgomery, K. Kaplan, D.H. Elwyn, Physiologic patterns in surviving and nonsurviving shock patients, Arch Surg. 106: 630, 1973.CrossRefGoogle Scholar
  14. 14.
    W.C. Shoemaker, Analysis of physiologic mechanisms in various etiologic types of clinical shock from sequential cardiorespiratory measurements. In, Shock in Low-and-High-Flow States, B.K. Forscher, R.C. Lillehei, S.S. Stubbs, Eds., Amsterdam, Excerpta Med, 1972.Google Scholar
  15. 15.
    W.C. Shoemaker and L.S.C. Czer, Evaluation of the biologic importance of various hemodynamic and oxygen transport variables, Crit. Care Med. 7: 424, 1979.CrossRefGoogle Scholar
  16. 16..
    K.K. Tremper, K. Waxman, and W.C. Shoemaker, Effects of hypoxia and shock on transcutaneous P02 values in dogs, Crit. Care Med. 7: 526, 1970.CrossRefGoogle Scholar
  17. 17.
    K.K. Tremper, K. Waxman, R. Bowman, and W.C. Shoemaker, Continuous transcutaneous oxygen monitoring during respiratory failure, cardiac decompensation, cardiac arrest, and CPR, Crit. Care Med. 8: 377, 1980.CrossRefGoogle Scholar
  18. 18.
    K.K. Tremper, and R.F. Huxtable, Dermal heat transport analysis for transcutaneous 02 measurement, Acta. Anaestha. Scan. (Suppl) 68: 4, 1978.Google Scholar
  19. 19.
    K.K. Tremper, and W.C. Shoemaker, Transcutaneous oxygen monitoring of critically ill adults, with and without low flow shock, Crit. Care Med. 9: 1981.Google Scholar
  20. 20.
    W.C. Shoemaker, and D. Vidyasagar, Physiologic and clinical significance of Ptc02 and PtcCO2 measurements. Crit. Care Med., 1981, In Press.Google Scholar
  21. 21.
    K.K. Tremper, R.A. Mentelos, and W.C. Shoemaker, Effects of hypercarbia and shock on transcutaneous carbon dioxide at different electrode temperatures, Crit. Care Med. 8: 709, 1980.Google Scholar
  22. 22.
    K.K. Tremper, W.C. Shoemaker, C.R. Shippy, and L.S. Nolan, Transcutaneous CO2 monitoring in adult patients in the ICU and operating room, Crit. Care Med., 1981, In Press.Google Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • William C. Shoemaker
    • 1
    • 2
  • Kevin K. Tremper
    • 1
    • 2
  1. 1.Department of SurgeryLos Angeles County Harbor UCLA Medical CenterTorranceUSA
  2. 2.UCLA School of MedicineLos AngelesUSA

Personalised recommendations