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REVIEW

The Design, Use, and Results of Transcutaneous Carbon Dioxide Analysis: Current and Future Directions

From Radiometer Basel AG, Basel, Switzerland.

Address correspondence and reprint requests to Patrick Eberhard, PhD, Radiometer-Basel, Austrasse 25, 4051 Basel, Switzerland. Address e-mail to patrick.eberhard{at}radiometer-basel.ch.

Abstract

Transcutaneous carbon dioxide (CO₂) analysis was introduced in the early 1980s using locally heated electrochemical sensors that were applied to the skin surface. This methodology provides a continuous noninvasive estimation of the arterial CO₂ value and can be used for assessing adequacy of ventilation. The technique is now established and used routinely in clinical practice. Transcutaneous partial pressure of CO₂ (tcPco₂) sensors are available as a single Pco₂ sensor, as a combined Pco₂/Po₂ sensor, and more recently, as a combined Pco₂/Spo₂ sensor. CO₂ is still measured potentiometrically by determining the pH of an electrolyte layer. The methodology has been continuously developed during the last 20 yr, making the tcPco₂ systems easier and more reliable for use in clinical practice: smaller sensor size (diameter 15 mm, height 8 mm), less frequent sensor re-membraning (every 2 wk) and calibration (twice a day), sensor ready to use when connected to the monitor, lower sensor temperature (42°C or less), shorter arterialization time (3 min), and increased measurement reliability through protection of the membrane. The present tcPco₂ sensors still need to be regularly re-membraned and calibrated. One way to overcome these procedures is to use optical-only detection means. Two techniques have been developed using optical absorption in the near-infrared light, in the evanescent wave of a waveguide integrated in the sensor surface, or in a micro-optics sampling cell. Preliminary in vitro and in vivo CO₂ measurements have been performed. The sensor is not affected by drift over several days, and its response time is <1 min.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999