Research ArticleAARC Clinical Practice Guideline

AARC Clinical Practice Guideline: Transcutaneous Monitoring of Carbon Dioxide and Oxygen: 2012

Ruben D Restrepo, Keith R Hirst, Leonard Wittnebel and Richard Wettstein
Respiratory Care November 2012, 57 (11) 1955-1962; DOI: https://doi.org/10.4187/respcare.02011

Abstract

An electronic literature search for articles published between January 1990 and September 2011 was conducted by using the PubMed, CINAHL, SCOPUS, and Cochrane Library databases. The update of this clinical practice guideline is the result of reviewing a total of 124 articles: 3 randomized controlled trials, 103 prospective trials, 1 retrospective study, 3 case studies, 11 review articles, 2 surveys and 1 consensus paper on transcutaneous monitoring (TCM) for PtcO2 and PtcCO2. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria: (1) Although PtcCO2 has a good correlation with PaCO2 and is a reliable method to evaluate plasma CO2 levels, it is recommended that arterial blood gas values be compared to transcutaneous readings taken at the time of arterial sampling, in order to verify the transcutaneous values, and periodically as dictated by the patient's clinical condition. (2) It is suggested that PtcCO2 may be used in clinical settings where monitoring the adequacy of ventilation is indicated. (3) It is suggested that PtcO2 and PtcCO2 may be used in determining the adequacy of tissue perfusion and monitoring of reperfusion. (4) It is suggested that TCM should be avoided in the presence of increased thickness or edema of the skin and/or subcutaneous tissue where the sensor is applied. (5) It is recommended that sites used for a TCM be changed as often as necessary and that they be alternated and observed to avoid thermal injury. Manufacturer recommendations should be followed.

TCM 1.0 INTRODUCTION

Since pulse oximetry is considered the standard of care for noninvasive monitoring of oxygen levels, routine transcutaneous monitoring (TCM) of oxygen pressure (PtcO2) has fallen out of favor. While some studies in infants1–3 have shown that TCM of PO2 may be more reliable than monitoring oxygenation via SpO2, most of the studies are focused on TCM of carbon dioxide pressure (PtcCO2), which is considered an accurate and clinically acceptable estimate of the PaCO2.4–13

TCM 2.0 DESCRIPTION/DEFINITION

A transcutaneous (TC) monitor measures the skin-surface PO2 and PCO2 to provide an estimate of the PaO2 and PaCO2. The measurements obtained include PtcO2 and PtcCO2. The TC monitor device induces hyperperfusion of the capillaries by increasing the local temperature of the skin at the sensor site. The externally applied heat alters the solubility of CO2 in the blood and increases the metabolic rate of the skin by approximately 4–5% for every degree Celsius, resulting in local production of CO2.14 The sensor, usually a Severinghaus electrode, will calculate the PCO2 electrochemically, usually by a change in pH of an electrolyte solution. Additionally, a temperature correction is used to address the epithelial CO2 produced by heating the skin.1,15–20 A Clark electrode, which is composed of a platinum cathode and silver anode, measures the PO2.21

Each manufacturer's calibration protocol for the TC monitor sensor should be followed. After the sensor is calibrated, the skin must be cleaned of all oils, soaps, and dead skin. Once the site is cleaned, then a sensor fixation ring should be placed in a highly vascularized area. The preferred location to obtain TC measurements in neonates and small pediatric patients is the upper chest. Alternative sites may be the lateral side of the abdomen, chest, buttock, inside of the upper thigh, forearm, the zygomatic bone, the ear lobe, cheeks, or the forehead.22–26 In order to achieve accurate PtcO2 the skin probe temperature must be 44°C, which may lead to injury or burning of the skin, particularly in patients with thin or damaged skin.27 By contrast, monitoring of the PtcCO2 is reliable with skin temperature even as low as 37°C.1,28 Most TC monitors allow the reduction of the probe temperature to minimize the risk of thermal injury.29 Correlation with arterial blood gases is recommended to ensure accuracy of the values obtained by TC monitor.29 When monitoring PtcCO2 only, use of lower skin probe temperatures increases the systematic overriding of TC measurement and may allow for longer periods of contact time between the skin and the sensor, for up to 8–12 hours. This option may be especially important for neonatal population compliance with the minimal handling approach promoted in their care. However, changing sites as often as every 2 hours may be necessary in small premature neonates to avoid thermal injury.

After the fixation device is in place, 1–2 drops of either contact gel or normal saline should be placed inside the ring. This improves the accuracy of the sensor and makes the diffusion of gases more efficient. The sensor is then placed into the ring and usually snaps into place. The ring must create enough of a seal to prevent leaks or formation of air bubbles, as ambient air reaching the sensor affects measured values.

TCM 3.0 SETTING

TCM may be performed by trained personnel in a variety of settings that include, but are not limited to hospitals, extended care facilities, and patient transport.20,22,30 It is utilized in the following specific clinical settings to determine the presence of hypoventilation or respiratory depression:

  • 3.1 Mechanical ventilation, including conventional modes of ventilation,31–33 high-frequency ventilation,27,34 steady state high frequency jet ventilation,35 and noninvasive ventilation.34–39

  • 3.2 Bronchoscopies or procedures requiring sedation23,40–45 or patient-controlled analgesia46–48

    • 3.2.1 Prolonged laparoscopic surgery procedures49

  • 3.3 Sleep studies50–55

    • 3.3.1 PtcO2 may have an increased role in detecting sleep hypoventilation and assessing the efficacy of treatment of sleep disorders.56

  • 3.4 Pulmonary function studies, including stress testing and bronchoprovocation12,39,57–59

  • 3.5 Trending HCO3– in diabetic ketoacidosis60

  • 3.6 Apnea testing61

  • 3.7 Transportation of a patient9,29

  • 3.8 Evaluation of tissue perfusion27,43,62–67

  • 3.9 Evaluation of postoperative hypercarbia9,68,69

  • 3.10 Evaluation of hyperventilation during phonation of patients with vocal cord disorders70,71

  • 3.11 Titration of long-term oxygen therapy72

TCM 4.0 INDICATIONS

The use of TCM is indicated in patients who either lack arterial access or have the need for continuous monitoring of oxygen and carbon dioxide with minimal blood draws.60 TCM allows the assessment of:

  • 4.1 adequacy of oxygenation and/or ventilation2,9,10,13,22,25,29,30,37,50,73–76

  • 4.2 response to diagnostic and therapeutic interventions, as evidenced by PtcO2 and/or PtcCO2 values2,22,29,30,37,38,64,67,74,77

    • 4.2.1 Weaning and extubation decisions may be made based on PtcCO2 measurement alone.78,79

  • 4.3 TC oxygen index (PtcO2/FIO2), which can be used as an early marker of hypoperfusion and mortality62,63

    • 4.3.1 A ratio less than 200 should prompt evaluation and intervention.61

  • 4.4 tissue perfusion status and revascularization in wound care and peripheral arterial occlusive disease80

    • 4.4.1 PtcO2 is used in wound care and hyperbaric oxygen therapy as an effective tool to monitor critical limb ischemia.

      • 4.4.1.1 A PtcO2 on the affected limb should be maintained between 30–40 mm Hg to maintain adequate perfusion. A PtcO2 less than 30 mm Hg may indicate poor perfusion to that limb, and a PtcO2 less than 10 mm Hg is considered incompatible with spontaneous healing process.81,82

      • 4.4.1.2 PtcO2 is useful in the determination of optimal amputation level. A PtcO2 of 30 mm Hg is considered the critical dividing value that separates successful from unsuccessful amputation stump healing.

  • 4.5 monitoring response to therapy in patients with diabetic ketoacidosis, as PtcCO2 correlates with serum HCO3– levels59

TCM 5.0 CONTRAINDICATIONS

There are no documented absolute contraindications for use of TCM. In patients with poor skin integrity and/or adhesive allergy, alternative monitoring devices to TCM should be considered.29

TCM 6.0 HAZARDS/COMPLICATIONS

PtcO2 and/or PtcCO2 monitoring is considered a safe procedure. The most common hazards and complications of TCM are:

  • 6.1 Misinterpretation of falsely elevated or decreased levels of O2 and CO2 that may lead to inappropriate treatment of the patient.75,83,84 PtcO2 underestimates PaO2 and PtcCO2 overestimates PaCO2. While some manufacturers have incorporated correction factors into the device software, what TCM really measures is skin PO2 and PCO2, not PaO2 and PaCO2 per se.75,83,84

  • 6.2 Thermal injury may occur at the sensor site (eg, erythema, blisters, burns, skin tears).10,16,22,85–87

TCM 7.0 DEVICE LIMITATIONS/VALIDATION OF RESULTS

PtcO2 is an indirect measurement of PaO2 and does not reflect oxygen delivery or oxygen content. Complete assessment of oxygen delivery requires knowledge of hemoglobin saturation and cardiac output. PtcCO2 is an indirect measurement of PaCO2, but knowledge of delivery and content is not necessary to use PtcCO2 for assessment of ventilation.

Factors that may affect readings, limit precision, or limit the performance or application of a TC monitor include:

  • 7.1 Device Related

    • 7.1.1. Although some newer designs make application quicker and simpler, setup is labor intensive.33

    • 7.1.2 Prolonged stabilization time is required following electrode placement, typically up to 5–10 min, but varies by manufacturer.9,33,38,84,88

    • 7.1.3 While the theoretical basis for mandatory heating of the PtcO2 electrode in newer TC monitors has not been established,17,89,90 manufacturers suggest heating the electrode to produce valid results.

      • 7.1.3.1 Some clinical studies suggest that valid results may be obtained with PtcCO2 electrodes operated at lower than recommended temperatures or with no heat.14,27,91,92

    • 7.1.4 Improper calibration, trapped air bubbles, leaks in the fixation device, and damaged membranes and their detection may result in misinterpretation of the values and erroneous changes in therapy.14,21,30,84

      • 7.1.4.1 If too much saline or contact gel is applied, a leak may be created between the skin and the fixation device.

  • 7.2 Clinical

    The following clinical situations may result in falsely elevated or decreased PtcO2 and PtcCO2 values:

    • 7.2.1 Presence of hyperoxemia (PaO2 > 100 mm Hg) (elevated PtcO2)14,86,89

    • 7.2.2 The presence of a hypoperfused state (shock, acidosis)61,93 and vasoactive drug administration61 may result in decreased PtcO2 and PtcCO2. However, the use of newer TCM devices and placement of the sensor near the carotid artery have improved the correlation between PaO2 and or PaCO2 in this clinical situation.4,25,31,45,55,83,94

    • 7.2.3 Improper electrode placement or application (elevated PtcO2; decreased PtcCO2)84

    • 7.2.4 Increased thickness or edema of the skin and/or subcutaneous tissue (decreased PtcO2 and PtcCO2)24,53,61,84,95

    • 7.2.5 Increased capillary blood flow induced by movement of the patient, either by self or due to routine care, may increase PtcO2 and PtcCO2.22,96,97

    • 7.2.6 Placement of the sensor site on the distal part of an extremity may result in lower readings, due to vasoconstriction limiting blood flow.14,15,24

      • 7.2.6.1 Some TC monitors allow for the use of the ear area (eg, tragus) as a TC monitoring site. Studies have shown that the ear is an acceptable place for TC monitoring8,25,27,98; however, in some cases the ear is not an acceptable place, as it may interfere with a procedure (eg, neurosurgery, maxillofacial surgery).

      • 7.2.6.2 The ear sensor is less susceptible to detachment with patient movement and does not have to be removed for chest x-rays or other chest imaging procedures.22,45

  • 7.3 Validation

    Arterial blood gas values should be compared to TC readings taken at the time of arterial sampling, in order to validate the TC values. This validation should be performed initially and periodically, as dictated by the patient's clinical condition.10,99–102

    • 7.3.1 During validation studies in patients with physiologic shunts, the electrode site and arterial sampling site should be on the same side of the shunt when measuring PtcO2.50,84,102 However, recent studies show that PtcCO2 is not affected by shunts or ventilation-perfusion mismatching, when compared to PaCO2.9,17,103

    • 7.3.2 When a discrepancy exists between TC, measured arterial values, and the clinical presentation of the patient, possible causes should be explored before results are reported. Monitoring at alternative sites, recalibration, or equipment replacement may reduce discrepancies. If such steps do not remedy the disparity, TCM results should not be acted upon or recorded in the patient's medical record. Instead, a statement describing the TC use and the corrective action should be included in the patient's medical documentation, and some other mode of monitoring should be established (eg, pulse oximetry, end-tidal CO2 [PETCO2] monitoring, arterial blood analysis). The absolute limits that constitute unacceptable discrepancies vary with patient condition and specific device.92,104,105 Clinical judgment must be exercised.

    • 7.3.3 When comparing or correlating values for PCO2, the PtcCO2 value is typically higher than PaCO2. However, the PtcCO2 is a good surrogate of the PaCO2 and sometimes and may provide a better estimate of PaCO2 than PETCO2.10,11,27,31,68,74,106–110 Reading an accurate PCO2 value with a TC monitor requires more time than measuring PETCO2, due to the required period of stabilization of the TCM.102,111

      • 7.3.3.1 Although the acceptable clinical range of agreement for PtcCO2 is ± 7.5 mm Hg,4 the manufacturer's recommendations should be followed.

TCM 8.0 ASSESSMENT OF NEED

  • 8.1 When direct measurement of arterial blood is not available or accessible in a timely fashion, PtcO2 and/or PtcCO2 measurements may temporarily suffice if the limitations of the data are appreciated.11

  • 8.2 TC blood gas monitoring is appropriate for continuous and prolonged monitoring (eg, during mechanical ventilation, CPAP, and supplemental oxygen administration), but has limitations when used on an intermittent basis.10,14,49,75

  • 8.3 PtcO2 values can be used for diagnostic purposes, as in the assessment of functional shunts (eg, persistent pulmonary hypertension of the newborn) or persistent fetal circulation, or to determine the response to oxygen challenge in the assessment of congenital heart disease.39,67,99,100

TCM 9.0 ASSESSMENT OF OUTCOME

  • 9.1 Results should reflect the patient's clinical condition (ie, validate the basis for ordering the monitoring).15,18,30,97

  • 9.2 Documentation of results, therapeutic intervention, and/or clinical decisions based on the TC measurements should be noted in the patient's medical record.

TCM 10.0 RESOURCES

  • 10.1 Equipment

    TC monitor, electrodes, calibration gases, and associated supplies. TC monitor should have been validated by the manufacturer, using appropriate quality control procedures and clinical reliability studies.

    In order to help assure consistency of care based on TC blood gas readings, the operator should verify:

    • 10.1.1 High and low limit alarms are set appropriately

    • 10.1.2 Appropriate electrode temperature is set

    • 10.1.3 Electrode placement site is appropriate and systematic electrode site change occurs

    • 10.1.4 Specific manufacturer's recommendations for maintenance, operation, and safety are complied with

      • 10.1.4.1 Some devices incorporate newer technologies to improve monitoring of oxygen and carbon dioxide by:

        • 10.1.4.1.1 allowing measurement of SpO2, PtcO2, and PtcCO2, together or separately, through a miniaturized carbon dioxide tension PCO2/SpO2 single sensor that monitors both PaCO2 and oxygen saturation by pulse oximetry (SpO2)22,25

        • 10.1.4.1.2 stabilizing TC values faster through the addition of a heat function

        • 10.1.4.1.3 showing the clinician, through a relative heating index, how much power the unit is using to warm the site

        • 10.1.4.1.4 maximizing measurement in low perfusion states through the incorporation of a compensatory heating probe

  • 10.2 Personnel

    Actively licensed and credentialed respiratory therapists or other credentialed healthcare providers with equivalent training and demonstrated ability to exercise the necessary clinical judgment, to assess the patient, and to perform the essential tasks of monitor calibration and application.10

TCM 11.0 MONITORING

The monitoring schedule of patient and equipment during TCM should be integrated into the patient assessment and vital signs determinations. Results should be documented in the medical record and should detail the conditions under which the readings were obtained. Additional documentation includes:

  • 11.1 The date and time of measurement, TC reading, patient's position, respiratory rate, and activity level

  • 11.2 FIO2 or supplemental oxygen flow, specifying the type of oxygen delivery device

  • 11.3 Ventilatory mode and settings

  • 11.4 Electrode placement site, electrode temperature, and time of placement

  • 11.5 Results of simultaneously obtained PaO2, PaCO2, and pH when available

  • 11.6 Clinical appearance of the patient, subjective assessment of perfusion, pallor, and skin temperature

TCM 12.0 FREQUENCY

TC blood gas monitoring should be continuous for development of trending data. Placement for intermittent and short duration measurements (ie, spot checks) is not appropriate.15,50,112

TCM 13.0 INFECTION CONTROL

No special precautions are necessary, but standard precautions (as described by the Centers for Disease Control) are recommended.113

  • 13.1 The device probe should be cleaned between patient applications, according to manufacturer recommendations.

  • 13.2 The external portion of the monitor should be cleaned by methods according to manufacturer recommendations in between patient use.

TCM 14.0 RECOMMENDATIONS

The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)114 criteria:

  • 14.1 Although PtcCO2 has a good correlation with PaCO2 and is a reliable method to evaluate plasma CO2 levels, it is recommended that arterial blood gas values be compared to TC readings taken at the time of arterial sampling, in order to verify the TC values, and periodically as dictated by the patient's clinical condition. (1A)

  • 14.2 It is suggested that PtcCO2 may be used in clinical settings where monitoring the adequacy of ventilation is indicated. (2B)

  • 14.3 It is suggested that PtcO2 and PtcCO2 may be used in determining the adequacy of tissue perfusion and monitoring of reperfusion. (2B)

  • 14.4 It is suggested that TCM should be avoided in the presence of increased thickness or edema of the skin and/or subcutaneous tissue where the sensor is applied. (2B)

  • 14.5 It is recommended that sites used for a TCM be changed as often as necessary and that they be alternated and observed to avoid thermal injury. Manufacturer recommendations should be followed. (1C)

TCM 15.0 CPG IDENTIFYING INFORMATION AND AVAILABILITY

  • 15.1 Adaptation

    Original Publication: Respiratory Care 1994:39(12):1176–1179.

  • 15.2 Guideline Developer

    American Association for Respiratory Care Clinical Practice Guidelines Steering Committee.

    Ruben D Restrepo MD RRT FAARC (Chair), Department of Respiratory Care, The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas.

    Keith R Hirst MSc RRT-NPS (Member), Department of Respiratory Care, Rush University, Chicago, Illinois.

    Leonard Wittnebel MSIS RRT (Member), Department of Respiratory Care, The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas

    Richard Wettstein MMEd RRT (Member), Department of Respiratory Care, The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas

  • 15.3 Source(s) of Funding

    None

  • 15.4 Financial Disclosures/Conflicts of Interest

    No conflicts of interest

Footnotes

  • Correspondence: Ruben D Restrepo MD RRT FAARC, Department of Respiratory Care, The University of Texas Health Science Center at San Antonio, MSC 6248, San Antonio TX 78229. E-mail: restrepor{at}uthscsa.edu.

  • Dr Restrepo has disclosed relationships with Oridion and Teleflex.

  • The other authors have disclosed no conflicts of interest.

References

  1. 1.↵
    1. Eberhard P
    . The design, use, and results of transcutaneous carbon dioxide analysis: current and future directions. Anesth Analg 2007;105(6 Suppl):S48–S52.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Quine D,
    2. Stenson BJ
    . Does the monitoring method influence stability of oxygenation in preterm infants? A randomised crossover study of saturation versus transcutaneous monitoring. Arch Dis Child Fetal Neonatal Ed 2008;93(5):F347–F350.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    1. Rüdiger M,
    2. Töpfer K,
    3. Hammer H,
    4. Schmalisch G,
    5. Wauer RR
    . A survey of transcutaneous blood gas monitoring among european neonatal intensive care units. BMC Pediatr 2005;5:30.
    OpenUrlPubMed
  4. 4.↵
    1. Bendjelid K,
    2. Schutz N,
    3. Stotz M,
    4. Gerard I,
    5. Suter PM,
    6. Romand JA
    . Transcutaneous PCO2 monitoring in critically ill adults: clinical evaluation of a new sensor. Crit Care Med 2005;33(10):2203–2206.
    OpenUrlCrossRefPubMed
  5. 5.
    1. Fuke S,
    2. Miyamoto K,
    3. Ohira H,
    4. Ohira M,
    5. Odajima N,
    6. Nishimura M
    . Evaluation of transcutaneous CO2 responses following acute changes in PaCO2 in healthy subjects. Respirology 2009;14(3):436–442.
    OpenUrlCrossRefPubMed
  6. 6.
    1. Lagerkvist AL,
    2. Sten G,
    3. Redfors S,
    4. Holmgren D
    . Repeated blood gas monitoring in healthy children and adolescents by the transcutaneous route. Pediatr Pulmonol 2003;35(4):274–279.
    OpenUrlPubMed
  7. 7.
    1. McVicar J,
    2. Eager R
    . Validation study of a transcutaneous carbon dioxide monitor in patients in the emergency department. Emerg Med J 2009;26(5):344–346.
    OpenUrlAbstract/FREE Full Text
  8. 8.↵
    1. Rodriguez P,
    2. Lellouche F,
    3. Aboab J,
    4. Buisson CB,
    5. Brochard L
    . Transcutaneous arterial carbon dioxide pressure monitoring in critically ill adult patients. Intensive Care Med 2006;32(2):309–312.
    OpenUrlCrossRefPubMed
  9. 9.↵
    1. Tingay DG,
    2. Stewart MJ,
    3. Morley CJ
    . Monitoring of end tidal carbon dioxide and transcutaneous carbon dioxide during neonatal transport. Arch Dis Child Fetal Neonatal Ed 2005;90(6):F523–F526.
    OpenUrlAbstract/FREE Full Text
  10. 10.↵
    1. JD,
    2. Wilson WR Jr.,
    3. Meyer DJ
    . Transcutaneous monitoring of carbon dioxide tension after cardiothoracic surgery in infants and children. Anesth Analg 1999;88(3):531–534.
    OpenUrlPubMed
  11. 11.↵
    1. Wilson J,
    2. Russo P,
    3. Russo J,
    4. Tobias JD
    . Noninvasive monitoring of carbon dioxide in infants and children with congenital heart disease: end-tidal versus transcutaneous techniques. J Intensive Care Med 2005;20(5):291–295.
    OpenUrlAbstract/FREE Full Text
  12. 12.↵
    1. Sandberg KL,
    2. Brynjarsson H,
    3. Hjalmarson O
    . Transcutaneous blood gas monitoring during neonatal intensive care. Acta Pædiatrica 2011;100(5):676–679.
    OpenUrl
  13. 13.↵
    1. Gancel PE,
    2. Roupie E,
    3. Guittet L,
    4. Laplume S,
    5. Terzi N
    . Accuracy of a transcutaneous carbon dioxide pressure monitoring device in emergency room patients with acute respiratory failure. Intensive Care Med 2011;37(2):348–351.
    OpenUrlCrossRefPubMed
  14. 14.↵
    1. Tobias JD
    . Transcutaneous carbon dioxide monitoring in infants and children. Pediatr Anesth 2009;19(5):434–444.
    OpenUrl
  15. 15.↵
    1. Huch R,
    2. Huch A,
    3. Albani M,
    4. Gabriel M,
    5. Schulte F,
    6. Wolf H,
    7. et al
    . Transcutaneous PO2 monitoring in routine management of infants and children with cardiorespiratory problems. Pediatrics 1976;57(5):681–690.
    OpenUrlAbstract/FREE Full Text
  16. 16.↵
    1. Lofgren O,
    2. Jacobson L
    . The influence of different electrode temperature on the recorded transcutaneous PO2 level. Pediatrics 1979;64(6):892–897.
    OpenUrlAbstract/FREE Full Text
  17. 17.↵
    1. Dietrich W,
    2. Lubbers P
    . Theoretical basis of the transcutaneous blood gas measurements. Crit Care Med 1981;9(10):721–733.
    OpenUrlCrossRefPubMed
  18. 18.↵
    1. Yahav J,
    2. Levison H
    . The validity of the transcutaneous oxygen tension method in children with cardiorespiratory problems. Am Rev Respir Dis 1981;124(5):586–587.
    OpenUrlPubMed
  19. 19.
    1. Monaco F,
    2. Nickerson B,
    3. McQuitty J
    . Continous transcutaneous oxygen and carbon dioxide monitoring in the pediatric ICU. Crit Care Med 1982;10(11):765–766.
    OpenUrlPubMed
  20. 20.↵
    1. Yip W,
    2. Tay J,
    3. Wong H,
    4. Ho T
    . Reliability of transcutaneous oxygen monitoring of critically iII children in a general pediatric unit. Clin Pediatr 1983;22(6):431–435.
    OpenUrlAbstract/FREE Full Text
  21. 21.↵
    1. Joyce A,
    2. Wahr M,
    3. Tremper K
    . Noninvasive oxygen monitoring techniques. Crit Care Clin 1995;11(1):199–217.
    OpenUrlPubMed
  22. 22.↵
    1. Dullenkopf A,
    2. Bernardo SD,
    3. Berger F,
    4. Fasnacht M,
    5. Gerber AC,
    6. Weiss M
    . Evaluation of a new combined SpO2/PtcCO2 sensor in anaesthetized paediatric patients. Paediatr Anaesth 2003;13(9):777–784.
    OpenUrlCrossRefPubMed
  23. 23.↵
    1. Fruchter O,
    2. Carmi U,
    3. Ingenito EP,
    4. Refaeli Y,
    5. Kramer MR
    . Transcutaneous carbon dioxide in severe COPD patients during bronchoscopic lung volume reduction. Respir Med 2011;105(4):602–607.
    OpenUrlPubMed
  24. 24.↵
    1. Nishiyama T,
    2. Nakamura S,
    3. Yamashita K
    . Comparison of the transcutaneous oxygen and carbon dioxide tension in different electrode locations during general anaesthesia. Eur J Anaesthesiol 2006;23(12):1049–1054.
    OpenUrlPubMed
  25. 25.↵
    1. Senn O,
    2. Clarenbach CF,
    3. Kaplan V,
    4. Maggiorini M,
    5. Bloch KE
    . Monitoring carbon dioxide tension and arterial oxygen saturation by a single earlobe sensor in patients with critical illness or sleep apnea. Chest 2005;128(3):1291–1296.
    OpenUrlCrossRefPubMed
  26. 26.↵
    1. Roediger R,
    2. Beck-Schimmer B,
    3. Theusinger OM,
    4. Rusch D,
    5. Seifert B,
    6. Spahn DR,
    7. et al
    . The revised digital transcutaneous PCO2/SpO2 ear sensor is a reliable noninvasive monitoring tool in patients after cardiac surgery. J Cardiothorac Vasc Anesth 2011;25(2):243–9.
    OpenUrlPubMed
  27. 27.↵
    1. Fanconi S,
    2. Tschupp A,
    3. Molinari L
    . Long-term transcutaneous monitoring of oxygen tension and carbon dioxide at 42 degrees C in critically ill neonates: improved performance of the tCPO2 monitor with topical metabolic inhibition. Eur J Pediatr 1996;155(12):1043–1046.
    OpenUrlCrossRefPubMed
  28. 28.↵
    1. Vallée F,
    2. Mateo J,
    3. Dubreuil G,
    4. Poussant T,
    5. Tachon G,
    6. Ouanounou I,
    7. Payen D
    . Cutaneous ear lobe PCO2 at 37 degrees C to evaluate microperfusion in patients with septic shock. Chest 2010;138(5):1062–1070.
    OpenUrlCrossRefPubMed
  29. 29.↵
    1. Molloy EJ,
    2. Deakins K
    . Are carbon dioxide detectors useful in neonates? Arch Dis Child Fetal Neonatal Ed 2006;91:F295–F298.
    OpenUrlAbstract/FREE Full Text
  30. 30.↵
    1. O'Connor TM,
    2. Grueber R
    . Transcutaneous measurement of carbon dioxide tension during long-distance transport of neonates receiving mechanical ventilation. J Perinatol 1998;18(3):189–192.
    OpenUrlPubMed
  31. 31.↵
    1. Berkenbosch JW,
    2. Lam J,
    3. Burd RS,
    4. Tobias JD
    . Noninvasive monitoring of carbon dioxide during mechanical ventilation in older children: end-tidal versus transcutaneous techniques. Anesth Analg 2001;92(6):1427–1431.
    OpenUrlPubMed
  32. 32.
    1. Tobias JD,
    2. Meyer DJ
    . Noninvasive monitoring of carbon dioxide during respiratory failure in toddlers and infants: end-tidal versus transcutaneous carbon dioxide. Anesth Analg 1997;85(1):55–58.
    OpenUrlCrossRefPubMed
  33. 33.↵
    1. Hazenberg A,
    2. Zijlstra JG,
    3. Kerstjens HA,
    4. Wijkstra PJ
    . Validation of a transcutaneous CO2 monitor in adult patients with chronic respiratory failure. Respiration 2011;81(3):242–246.
    OpenUrlPubMed
  34. 34.↵
    1. Berkenbosch JW,
    2. Tobias JD
    . Transcutaneous carbon dioxide monitoring during high-frequency oscillatory ventilation in infants and children. Crit Care Med 2002;30(5):1024–1027.
    OpenUrlCrossRefPubMed
  35. 35.↵
    1. Simon M,
    2. Gottschall R,
    3. Gugel M,
    4. Fritz H,
    5. Mohr S,
    6. Klein U
    . Comparison of transcutaneous and endtidal CO2-monitoring for rigid bronchoscopy during high-frequency jet ventilation. Acta Anaesthesiol Scand 2003;47(7):861–867.
    OpenUrlCrossRefPubMed
  36. 36.
    1. Tobias J
    . Noninvasive monitoring of carbon dioxide during respiratory failure in toddlers and infants: end tidal versus transcutaneous carbon dioxide. Anesth Analg 1997;85(1):55–58.
    OpenUrlCrossRefPubMed
  37. 37.↵
    1. Maniscalco M,
    2. Zedda A,
    3. Faraone S,
    4. Carratu P,
    5. Sofia M
    . Evaluation of a transcutaneous carbon dioxide monitor in severe obesity. Intensive Care Med 2008;34(7):1340–1344.
    OpenUrlCrossRefPubMed
  38. 38.↵
    1. Storre JH,
    2. Magnet FS,
    3. Dreher M,
    4. Windisch W
    . Transcutaneous monitoring as a replacement for arterial PCO2 monitoring during nocturnal non-invasive ventilation. Respir Med 2011;105(1):143–150.
    OpenUrlCrossRefPubMed
  39. 39.↵
    1. Storre JH,
    2. Steurer B,
    3. Kabitz HJ,
    4. Dreher M,
    5. Windisch W
    . Transcutaneous PCO2 monitoring during initiation of noninvasive ventilation. Chest 2007;132(6):1810–1816.
    OpenUrlCrossRefPubMed
  40. 40.↵
    1. Holmgren D,
    2. Redfors S,
    3. Solymar L
    . Transcutaneous-PO2 monitoring for detection of exercise-induced right-to-left shunts in children with congenital heart defects: a case report. Acta Paediatr 2001;90(7):816–818.
    OpenUrlPubMed
  41. 41.
    1. Chhajed PN,
    2. Rajasekaran R,
    3. Kaegi B,
    4. Chhajed TP,
    5. Pflimlin E,
    6. Leuppi J,
    7. et al
    . Measurement of combined oximetry and cutaneous capnography during flexible bronchoscopy. Eur Respir J 2006;28(2):386–390.
    OpenUrlAbstract/FREE Full Text
  42. 42.
    1. Evans EN,
    2. Ganeshalingam K,
    3. Ebden P
    . Changes in oxygen saturation and transcutaneous carbon dioxide and oxygen levels in patients undergoing fibreoptic bronchoscopy. Respir Med 1998;92(5):739–742.
    OpenUrlCrossRefPubMed
  43. 43.↵
    1. Tatevossian R,
    2. Wo C,
    3. Velmahos G,
    4. Demetriades D,
    5. Shoemaker W
    . Transcutaneous oxygen and CO2 as early warning of tissue hypoxia and hemodynamic shock in critically ill emergency patients. Crit Care Med 2000;28(7)2248–2253.
    OpenUrlPubMed
  44. 44.
    1. Heuss LT,
    2. Chhajed PN,
    3. Schnieper P,
    4. Hirt T,
    5. Beglinger C
    . Combined pulse oximetry/cutaneous carbon dioxide tension monitoring during colonoscopies: pilot study with a smart ear clip. Digestion 2004;70(3):152–158.
    OpenUrlPubMed
  45. 45.↵
    1. Pellicer A,
    2. Valverde E,
    3. Elorza MD,
    4. Madero R,
    5. Gayá F,
    6. Quero J,
    7. Cabañas F
    . Cardiovascular support for low birth weight infants and cerebral hemodynamics: a randomized, blinded, clinical trial. Pediatrics 2005;115(6):1501–1512.
    OpenUrlAbstract/FREE Full Text
  46. 46.↵
    1. Kopka A,
    2. Wallace E,
    3. Reilly G,
    4. Binning A
    . Observational study of perioperative PtcCO2 and SpO2 in non-ventilated patients receiving epidural infusion or patient-controlled analgesia using a single earlobe monitor (TOSCA). Br J Anaesth 2007;99(4):567–571.
    OpenUrlAbstract/FREE Full Text
  47. 47.
    1. McCormack JG,
    2. Kelly KP,
    3. Wedgwood J,
    4. Lyon R
    . The effects of different analgesic regimens on transcutaneous CO2 after major surgery. Anaesthesia 2008;63(8):814–821.
    OpenUrlPubMed
  48. 48.↵
    1. Nelson DB,
    2. Freeman ML,
    3. Silvis SE,
    4. Cass OW,
    5. Yakshe PN,
    6. Vennes J,
    7. et al
    . A randomized, controlled trial of transcutaneous carbon dioxide monitoring during ERCP. Gastrointest Endosc 2000;51(3):288–295.
    OpenUrlCrossRefPubMed
  49. 49.↵
    1. Qingsheng Xue,
    2. Xiaowen Wu,
    3. Jue Jin,
    4. Buwei Yu,
    5. Minhua Zheng
    . Transcutaneous carbon dioxide monitoring accurately predicts arterial carbon dioxide partial pressure in patients undergoing prolonged laparoscopic surgery. Anesth Analg 2010;111:417–420.
    OpenUrlCrossRefPubMed
  50. 50.↵
    1. Kirk VG,
    2. Batuyong ED,
    3. Bohn SG
    . Transcutaneous carbon dioxide monitoring and capnography during pediatric polysomnography. Sleep 2006;29(12):1601–1608.
    OpenUrlPubMed
  51. 51.
    1. Lucey JF
    . Clinical uses of transcutaneous oxygen monitoring. Adv Pediatr 1981;28:27–56.
    OpenUrlPubMed
  52. 52.
    1. Randerath WJ,
    2. Stieglitz S,
    3. Galetke W,
    4. Anduleit N,
    5. Treml M,
    6. Schafer T
    . Evaluation of a system for transcutaneous long-term capnometry. Respiration 2010;80(2):139–145.
    OpenUrlPubMed
  53. 53.↵
    1. Rauhala E,
    2. Himanen SL,
    3. Saastamoinen A,
    4. Polo O
    . Prolonged spiking in the Emfit sensor in patients with sleep-disordered breathing is characterized by increase in transcutaneous carbon dioxide. Physiol Meas 2007;28(10):1163–1173.
    OpenUrlPubMed
  54. 54.
    1. Mok J,
    2. Pintar M,
    3. Benson L,
    4. McLaughlin FJ,
    5. Levison H
    . Evaluation of noninvasive measurements of oxygenation in stable infants. Crit Care Med 1986;14(11):960–963.
    OpenUrlPubMed
  55. 55.↵
    1. Virkki A,
    2. Polo O,
    3. Saaresranta T,
    4. Laapotti-Salo A,
    5. Gyllenberg M,
    6. Aittokallio T
    . Overnight features of transcutaneous carbon dioxide measurement as predictors of metabolic status. Artif Intell Med 2008;42(1):55–65.
    OpenUrlCrossRefPubMed
  56. 56.↵
    1. Carter B,
    2. Hochmann M,
    3. Osborne A,
    4. Nisbet A,
    5. Campbell N
    . A comparison of two transcutaneous monitors for the measurement of arterial PO2 and PCO2 in neonates. Anaesth Intensive Care 1995;23(6):708–714.
    OpenUrlPubMed
  57. 57.↵
    1. Holmgren D,
    2. Redfors S,
    3. Wennergren G,
    4. Sten G
    . Histamine provocation in young, awake children with bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction. Acta Paediatr 1999;88(5):545–549.
    OpenUrlCrossRefPubMed
  58. 58.
    1. Klug B,
    2. Bisgaard H
    . Measurement of lung function in awake 2-4-year-old asthmatic children during methacholine challenge and acute asthma: a comparison of the impulse oscillation technique, the interrupter technique, and transcutaneous measurement of oxygen versus whole-body plethysmography. Pediatr Pulmonol 1996;21(5):290–300.
    OpenUrlCrossRefPubMed
  59. 59.↵
    1. Stege G,
    2. van den Elshout FJ,
    3. Heijdra YF,
    4. van de Ven MJ,
    5. Dekhuijzen PN,
    6. Vos PJ
    . Accuracy of transcutaneous carbon dioxide tension measurements during cardiopulmonary exercise testing. Respiration 2009;78(2):147–153.
    OpenUrlPubMed
  60. 60.↵
    1. McBride ME,
    2. Berkenbosch JW,
    3. Tobias JD
    . Transcutaneous carbon dioxide monitoring during diabetic ketoacidosis in children and adolescents. Paediatr Anaesth 2004;14(2):167–171.
    OpenUrlPubMed
  61. 61.↵
    1. Lang CJ
    . Apnea testing guided by continuous transcutaneous monitoring of partial pressure of carbon dioxide. Crit Care Med 1998;26(5):868–872.
    OpenUrlPubMed
  62. 62.↵
    1. Martin M,
    2. Matthew Martina CB,
    3. Bayard D,
    4. Demetriades D,
    5. Salim A,
    6. Gertz R,
    7. et al
    . Continuous noninvasive monitoring of cardiac performance and tissue perfusion in pediatric trauma patients. J Pediatr Surg 2005;40:1957–1963.
    OpenUrlPubMed
  63. 63.↵
    1. Shoemaker WC,
    2. Wo CC,
    3. Demetriades D,
    4. Belzberg H,
    5. Asensio JA,
    6. Cornwell EE,
    7. et al
    . Early physiologic patterns in acute illness and accidents: toward a concept of circulatory dysfunction and shock based on invasive and noninvasive hemodynamic monitoring. New Horiz 1996;4(4):395–412.
    OpenUrlPubMed
  64. 64.↵
    1. Shoemaker WC,
    2. Wo CC,
    3. Lu K,
    4. Chien LC,
    5. Rhee P,
    6. Bayard D,
    7. et al
    . Noninvasive hemodynamic monitoring for combat casualties. Mil Med 2006;171(9):813–820.
    OpenUrlPubMed
  65. 65.
    1. Sugimoto I,
    2. Ohta T,
    3. Ishibashi H,
    4. Iwata H,
    5. Kawanishi J,
    6. Yamada T,
    7. et al
    . Transcutaneous carbon dioxide tension for the evaluation of limb ischemia. Surg Today 2009;39(1):9–13.
    OpenUrlPubMed
  66. 66.
    1. Tatevossian RG,
    2. Shoemaker WC,
    3. Wo CC,
    4. Dang AB,
    5. Velmahos GC,
    6. Demetriades D
    . Noninvasive hemodynamic monitoring for early warning of adult respiratory distress syndrome in trauma patients. J Crit Care 2000;15(4):151–159.
    OpenUrlCrossRefPubMed
  67. 67.↵
    1. Yu M,
    2. Morita SY,
    3. Daniel SR,
    4. Chapital A,
    5. Waxman K,
    6. Severino R
    . Transcutaneous pressure of oxygen: a noninvasive and early detector of peripheral shock and outcome. Shock 2006;26(5):450–456.
    OpenUrlCrossRefPubMed
  68. 68.↵
    1. Drummond KJ,
    2. Fearnside MR,
    3. Chee A
    . Transcutaneous carbon dioxide measurement after craniotomy in spontaneously breathing patients. Neurosurg 1997;41(2):361–365.
    OpenUrlCrossRefPubMed
  69. 69.↵
    1. Xue Q,
    2. Wu X,
    3. Jin J,
    4. Yu B,
    5. Zheng M
    . Transcutaneous carbon dioxide monitoring accurately predicts arterial carbon dioxide partial pressure in patients undergoing prolonged laparoscopic surgery. Anesth Analg 2010;111(2):417–420.
    OpenUrlCrossRefPubMed
  70. 70.↵
    1. Miyazaki H,
    2. Umezaki T,
    3. Yamashita H,
    4. Yamamoto T,
    5. Komiyama S
    . Transcutaneous PCO2 monitoring with hyperventilation during phonation in vocal cord paralysis. Auris Nasus Larynx 2002;29(3):277–282.
    OpenUrlPubMed
  71. 71.↵
    1. Miyazaki H,
    2. Yamashita H,
    3. Masuda T,
    4. Yamamoto T,
    5. Komiyama S
    . Transcutaneous PCO2 monitoring in the evaluation of hyperventilation of patients with recurrent nerve paralysis. Eur Arch Otorhinolaryngol 1999;256(Suppl 1):S47–S50.
    OpenUrlPubMed
  72. 72.↵
    1. Török SS,
    2. Leuppi JD,
    3. Baty F,
    4. Prashant MT,
    5. Chhajed N
    . Combined oximetry-cutaneous capnography in patients assessed for long-term oxygen therapy. Chest 2008;133:1421–1425.
    OpenUrlCrossRefPubMed
  73. 73.↵
    1. Martin RJ
    . Transcutaneous monitoring: instrumentation and clinical applications. Respir Care 1990;35(6):577–583.
    OpenUrl
  74. 74.↵
    1. Stausholm K,
    2. Rosenberg-Adamsen S,
    3. Edvardsen L,
    4. Kehlet H,
    5. Rosenberg J
    . Validation of pulse oximetry for monitoring of hypoxaemic episodes in the late postoperative period. Br J Anaesth 1997;78(1):86–87.
    OpenUrlAbstract/FREE Full Text
  75. 75.↵
    1. Urbano J,
    2. Cruzado V,
    3. Lopez-Herce J,
    4. del Castillo J,
    5. Bellon JM,
    6. Carrillo A
    . Accuracy of three transcutaneous carbon dioxide monitors in critically ill children. Pediatr Pulmonol 2010;45(5):481–486.
    OpenUrlPubMed
  76. 76.↵
    1. Weaver LK
    . Transcutaneous oxygen and carbon dioxide tensions compared to arterial blood gases in normals. Respir Care 2007;52(11):1490–1496.
    OpenUrlAbstract/FREE Full Text
  77. 77.↵
    1. Severinghaus JW
    . Transcutaneous blood gas analysis. Respir Care 1982;72(2):152–159.
    OpenUrl
  78. 78.↵
    1. Chakravarthy M,
    2. Narayan S,
    3. Govindarajan R,
    4. Jawali V,
    5. Rajeev S
    . Weaning mechanical ventilation after off-pump coronary artery bypass graft procedures directed by noninvasive gas measurements. J Cardiothorac Vasc Anesth 2010;24(3):451–455.
    OpenUrlPubMed
  79. 79.↵
    1. Johnson DC,
    2. Batool S,
    3. Dalbec R
    . Transcutaneous carbon dioxide pressure monitoring in a specialized weaning unit. Respir Care 2008;53(8):1042–1047.
    OpenUrlAbstract/FREE Full Text
  80. 80.↵
    1. Rodrigues LM,
    2. Pinto PC,
    3. Leal A
    . Transcutaneous flow related variables measured in vivo: the effects of gender. BMC Dermatol 2001;1:4.
    OpenUrlPubMed
  81. 81.↵
    1. Ruangsetakit C,
    2. Chinsakchai K,
    3. Mahawongkajit P,
    4. Wongwanit C,
    5. Mutirangura P
    . Transcutaneous oxygen tension: a useful predictor of ulcer healing in critical limb ischaemia. J Wound Care 2010;19(5):202–206.
    OpenUrlCrossRefPubMed
  82. 82.↵
    1. Chiriano J,
    2. Bianchi C,
    3. Teruya TH,
    4. Mills B,
    5. Bishop V,
    6. Abou-Zamzam AM
    . Management of lower extremity wounds in patients with peripheral arterial disease: a stratified conservative approach. Ann Vasc Surg 2010;24(8):1110–1116.
    OpenUrlCrossRefPubMed
  83. 83.↵
    1. Martin RJ,
    2. Robertson SS,
    3. Hopple MM
    . Relationship between transcutaneous and arterial oxygen tension in sick neonates during mild hyperoxemia. Crit Care Med 1982;10(10):670–672.
    OpenUrlPubMed
  84. 84.↵
    1. Steurer J,
    2. Hoffmann U,
    3. Dur P,
    4. Russi E,
    5. Vetter W
    . Changes in arterial and transcutaneous oxygen and carbon dioxide tensions during and after voluntary hyperventilation. Respiration 1997;64(3):200–205.
    OpenUrlPubMed
  85. 85.↵
    1. Mike V,
    2. Ross GS
    . Doctors and the health industry: a case study of transcutaneous oxygen monitoring in neonatal intensive care. Soc Sci Med 1996;42(9):1247–1258.
    OpenUrlPubMed
  86. 86.↵
    1. Lucia LD,
    2. Aliwalas M,
    3. Noble L,
    4. Nesbitt K,
    5. Fallah S,
    6. Shah V,
    7. Shah P
    . Agreement of carbon dioxide levels measured by arterial, transcutaneous, and end tidal methods in preterm infants ≤ 28 weeks gestation. J Perinatol 2005;25(1):26–29.
    OpenUrlCrossRefPubMed
  87. 87.↵
    1. Poets CF,
    2. Southall DP
    . Noninvasive monitoring of oxygenation in infants and children: practical considerations and areas of concern. Pediatrics 1994;93(5):737–746.
    OpenUrlAbstract/FREE Full Text
  88. 88.↵
    1. Kesten S,
    2. Chapman KR,
    3. Rebuck AS
    . Response characteristics of a dual transcutaneous oxygen/carbon dioxide monitoring system. Chest 1991;99(5):1211–1215.
    OpenUrlCrossRefPubMed
  89. 89.↵
    1. McLellan PA,
    2. Goldstein RS,
    3. Ramcharan V,
    4. Rebuck AS
    . Transcutaneous carbon dioxide monitoring. Am Rev of Respir Dis 1981;124(2):199–201.
    OpenUrl
  90. 90.↵
    1. Talbot A,
    2. Neuman MR,
    3. Saidel GM,
    4. Jacobsen E
    . Dynamic model of oxygen transport for transcutaneous PO2 analysis. Ann Biomed Eng 1996;24(2):294–304.
    OpenUrlPubMed
  91. 91.↵
    1. Rudiger M,
    2. Topfer K,
    3. Hammer H,
    4. Schmalisch G,
    5. Wauer RR
    . A survey of transcutaneous blood gas monitoring among European neonatal intensive care units. BMC Pediatr 2005;5:30.
    OpenUrlPubMed
  92. 92.↵
    1. Marsden D,
    2. Chiu MC,
    3. Paky F,
    4. Helms P
    . Transcutaneous oxygen and carbon dioxide monitoring in intensive care. Arch Dis Child 1985;60(12):1158–1161.
    OpenUrlAbstract/FREE Full Text
  93. 93.↵
    1. Versmold HT,
    2. Linderkamp O,
    3. Holzmann M,
    4. Strohhacker I,
    5. Riegel K
    . Transcutaneous monitoring of PO2 in newborn infants: where are the limits? Influence of blood pressure, blood volume, blood flow, viscosity, and acid base state. Birth Defects Orig Artic Ser 1979;15(4):285–294.
    OpenUrlPubMed
  94. 94.↵
    1. Vivien B,
    2. Marmion F,
    3. Roche S,
    4. Devilliers C,
    5. Langeron O,
    6. Coriat P,
    7. et al
    . An evaluation of transcutaneous carbon dioxide partial pressure monitoring during apnea testing in brain-dead patients. Anesthesiology 2006;104(4):701–707.
    OpenUrlPubMed
  95. 95.↵
    1. Nishiguchi BK,
    2. Yu M,
    3. Suetsugu A,
    4. Jiang C,
    5. Takiguchi SA,
    6. Takanishi DM Jr.
    . Determination of reference ranges for transcutaneous oxygen and carbon dioxide tension and the oxygen challenge test in healthy and morbidly obese subjects. J Surg Res 2008;150(2):204–211.
    OpenUrlPubMed
  96. 96.↵
    1. Planes C,
    2. Leroy M,
    3. Foray E,
    4. Raffestin B
    . Arterial blood gases during exercise: validity of transcutaneous measurements. Arch Phys Med Rehabil 2001;82(12):1686–1691.
    OpenUrlCrossRefPubMed
  97. 97.↵
    1. Verderber A,
    2. Gallagher KJ,
    3. Severino R
    . The effect of nursing interventions on transcutaneous oxygen and carbon dioxide tensions. West J Nurs Res 1995;17(1):76–90.
    OpenUrlAbstract/FREE Full Text
  98. 98.↵
    1. Bernet-Buettiker V,
    2. Ugarte MJ,
    3. Frey B,
    4. Hug MI,
    5. Baenziger O,
    6. Weiss M
    . Evaluation of a new combined transcutaneous measurement of PCO2/pulse oximetry oxygen saturation ear sensor in newborn patients. Pediatrics 2004;115(1):e64–e68.
    OpenUrlPubMed
  99. 99.↵
    1. Rosner V,
    2. Hannhart B,
    3. Chabot F,
    4. Polu JM
    . Validity of transcutaneous oxygen/carbon dioxide pressure measurement in the monitoring of mechanical ventilation in stable chronic respiratory failure. Eur Respir J 1999;13(5):1044–1047.
    OpenUrlAbstract/FREE Full Text
  100. 100.↵
    1. Brouillette RT,
    2. Waxman DH
    . Evaluation of the newborn's blood gas status. Clin Chem 1997;43(1):215–221.
    OpenUrlAbstract/FREE Full Text
  101. 101.
    1. Cassady G
    . Transcutaneous monitoring in the newborn infant. J Pediatr 1983;103(6):837–848.
    OpenUrlCrossRefPubMed
  102. 102.↵
    1. Pearlman SA,
    2. Maisels MJ
    . Preductal and postductal transcutaneous oxygen tension measurements in premature newborns with hyaline membrane disease. Pediatrics 1989;83(1):98–100.
    OpenUrlAbstract/FREE Full Text
  103. 103.↵
    1. Tateishi K,
    2. Yamanouchi I
    . Noninvasive transcutaneous oxygen pressure diagnosis of reversed ductal shunts in cyanotic heart disease. Pediatrics 1980;66(1):22–25.
    OpenUrlAbstract/FREE Full Text
  104. 104.↵
    1. Bolliger D,
    2. Steiner LA,
    3. Kasper J,
    4. Aziz OA,
    5. Filipovic M,
    6. Seeberger MD
    . The accuracy of non-invasive carbon dioxide monitoring: a clinical evaluation of two transcutaneous systems. Anaesthesia 2007;62(4):394–399.
    OpenUrlCrossRefPubMed
  105. 105.↵
    1. Wollburg E,
    2. Roth WT,
    3. Kim S
    . End-tidal versus transcutaneous measurement of PCO2 during voluntary hypo- and hyperventilation. Int J Psychophysiol 2009;71(2):103–108.
    OpenUrlPubMed
  106. 106.↵
    1. Casati A,
    2. Squicciarini G,
    3. Malagutti G,
    4. Baciarello M,
    5. Putzu M,
    6. Fanelli A
    . Transcutaneous monitoring of partial pressure of carbon dioxide in the elderly patient: a prospective, clinical comparison with end-tidal monitoring. J Clin Anesth 2006;18(6):436–440.
    OpenUrlCrossRefPubMed
  107. 107.
    1. Hirabayashi M,
    2. Fujiwara C,
    3. Ohtani N,
    4. Kagawa S,
    5. Kamide M
    . Transcutaneous PCO2 monitors are more accurate than end-tidal PCO2 monitors. J Anesth 2009;23(2):198–202.
    OpenUrlPubMed
  108. 108.
    1. Lopez E,
    2. Grabar S,
    3. Barbier A,
    4. Krauss B,
    5. Jarreau PH,
    6. Moriette G
    . Detection of carbon dioxide thresholds using low-flow sidestream capnography in ventilated preterm infants. Intensive Care Med 2009;35(11):1942–1949.
    OpenUrlCrossRefPubMed
  109. 109.
    1. McBride DS Jr.,
    2. Johnson JO,
    3. Tobias JD
    . Noninvasive carbon dioxide monitoring during neurosurgical procedures in adults: end-tidal versus transcutaneous techniques. South Med J 2002;95(8):870–874.
    OpenUrlPubMed
  110. 110.↵
    1. Nosovitch MA,
    2. Johnson JO,
    3. Tobias JD
    . Noninvasive intraoperative monitoring of carbon dioxide in children: endtidal versus transcutaneous techniques. Paediatr Anaesth 2002;12(1):48–52.
    OpenUrlCrossRefPubMed
  111. 111.↵
    1. Stein N,
    2. Schneeweiß A,
    3. Eckmann C,
    4. Roth-Isigkeit A,
    5. Hüppe M,
    6. Gehring H
    . An evaluation of a transcutaneous and an end-tidal capnometer for noninvasive monitoring of spontaneously breathing patients. Respir Care 2006;51(10):1162–1166.
    OpenUrlPubMed
  112. 112.↵
    1. Rauch DA,
    2. Ewig J,
    3. Benoit P,
    4. Clark E,
    5. Bijur P
    . Exploring intermittent transcutaneous CO2 monitoring. Crit Care Med 1999;27(11):2358–2360.
    OpenUrlPubMed
  113. 113.↵
    1. Jensen PA,
    2. Lambert LA,
    3. Iademarco MF,
    4. Ridzon R
    ; Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep 2005;54(RR-17):1–141.
    OpenUrlPubMed
  114. 114.↵
    1. Restrepo RD
    . AARC Clinical Practice Guidelines: from “reference-based” to “evidence-based” (editorial). Respir Care 2010;55(6):787–789.
    OpenUrlFREE Full Text
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