Skip to main content
Log in

Noninvasive monitoring of carbon dioxide: A comparison of the partial pressure of transcutaneous and end-tidal carbon dioxide with the partial pressure of arterial carbon dioxide

  • Original Articles
  • Published:
Journal of Clinical Monitoring Aims and scope Submit manuscript

Abstract

This study compares two noninvasive techniques for monitoring the partial pressure of carbon dioxide (Pco2) in 24 anesthetized adult patients. End-tidal PCO2 (PETCO2) and transcutaneous Pco2 (PtcCO2) were simultaneously monitored and compared with arterial Pco2 (PaCO2) determined by intermittent analysis of arterial blood samples. PETCO2 and PtcCO2 values were compared with PaCO2 values corrected to patient body temperature (PaC02T) and PaCO2 values determined at a temperature of 37°C (PaCO2). Linear regression was performed along with calculations of the correlation coefficient (r), bias, and precision of the four paired variables:PETCO2 versus PaCO2 and PaCO2T (n = 211), and PtcCO2 versus PaCO2 and PaCO2T (n = 233). Bias is defined as the mean difference between paired values, whereas precision is the standard deviation of the difference.

The following values were found forr, bias, and ± precision, respectively.PetCO2 versus PaCO2: 0.67, −7.8 mm Hg, ±6.1 mm Hg;PETCO2 versus PaCO2T: 0.73, −5.8 mm Hg, ±5.9 mm Hg;PETCO2 versus PaCO2: 0.87, −1.6 mm Hg, ±4.3 mm Hg; PtcCO2 versus PaC02T: 0.84, +0.7 mm Hg, ±4.8 mm Hg.

Although each of thesePCO 2 variables is physiologically different, there is a significant correlation (P < 0.001) between the noninvasively monitored values and the blood gas values. Temperature correction of the arterial values (PaCO2T) slightly improved the correlation, with respect toPETCO2, but it had the opposite effect for PtcCO2. In this study, the chief distinction between these two noninvasive monitors was thatPETCO2 had a large negative bias, whereas PtcCO2 had a small bias. We conclude from these data that PtcCO2 may be used to estimate PaCO2 with an accuracy similar to that ofPetCO2 in anesthetized patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nunn JF, Hill DW. Respiratory dead space and arterial to end-tidal CO2 tension difference in anesthetized man. J Appl Physiol 1960;15:383–389

    PubMed  CAS  Google Scholar 

  2. Whitesell R, Asiddao C, Gollman D, Jablonski J. Relationship between arterial and peak expired carbon dioxide pressure during anesthesia and factors influencing the difference. Anesth Analg 1981;60:508–512

    Article  PubMed  CAS  Google Scholar 

  3. Hightower CE, Kiorpes AL, Butler HC, Fedde MR. End-tidal partial pressure of CO2 as an estimate of arterial partial pressure of CO2 during various ventilatory regimens in halothane-anesthetized dogs. Am J Vet Res S1980;41:610–612

    PubMed  CAS  Google Scholar 

  4. Huch A, Lubbers DW, Huch R. Patientenuberwachung durch transcutane PCO2-Messung bei gleiechzeiliger Koutrolle der Relatiuen lokalen Perfusion. Anaesthesist 1973;22:379–381

    PubMed  CAS  Google Scholar 

  5. Hansen TN, Tooley WH. Skin surface carbon dioxide tension in sick infants. Pediatrics 1979;64:942–946

    PubMed  CAS  Google Scholar 

  6. Tremper KK, Shoemaker WC, Shippy CR, Nolan LS. Transcutaneous PCO2 monitoring in adult patients in the ICU and the operating room. Crit Care Med 1981;9:752–755

    Article  PubMed  CAS  Google Scholar 

  7. Rafferty TD, Marreso O, Nardi D, et al. Relationship between transcutaneous and arterial carbon dioxide tension in adult patients anesthetized with nitrous oxidefentanyl and nitrous oxide-enflurane. Anesth Analg 1981;60:504–507

    Article  PubMed  CAS  Google Scholar 

  8. Monaco F, McQuitty JC. Transcutaneous measurements of carbon dioxide partial pressure in sick neonates. Crit Care Med 1981;9:756–759

    Article  PubMed  CAS  Google Scholar 

  9. Monaco F, Nickerson BG, McQuitty JC. Continuous Soxygen and carbon dioxide monitoring in the pediatric ICU. Crit Care Med 1982;10:765–766

    Article  PubMed  CAS  Google Scholar 

  10. Rithalia SVS, Ng YY, Tinker J. Measurement of transcutaneous PCO2 in critically ill patients. Resuscitation 1982;10:13–18

    Article  PubMed  CAS  Google Scholar 

  11. Wimberly PD, Pedresen KG, Thode J, et al: Transcutaneous and capillary PCO2 and PO2 measurements in healthy adults. Clin Chem 1983;29:1471–1473

    Google Scholar 

  12. Monaco F, McQuitty JC, Nickerson BG. Calibration of a heated transcutaneous carbon dioxide electrode to reflect arterial carbon dioxide. Am Rev Respir Dis 1983;127:322–324

    PubMed  CAS  Google Scholar 

  13. Kelman GR, Nunn JF. Nomograms for correction of blood pO2, pCO2, pH and base excess for time and temperature. J Appl Physiol 1966;21:1484–1490

    PubMed  CAS  Google Scholar 

  14. Altman DG. Statistics and ethics in medical research. V. Analysing data. Br Med J 1980;281:1473–1475

    Article  PubMed  CAS  Google Scholar 

  15. Raemer DB, Francis D, Philip JH, Gabel RA. Variation in PCO2 between arterial blood and peak expired gas during anesthesia. Anesth Analg 1983;62:1065–1069

    Article  PubMed  CAS  Google Scholar 

  16. Brechner VL, Bethune RWM. Recent advances in monitoring pulmonary air embolism. Anesth Analg 1971;50:255–261

    Article  PubMed  CAS  Google Scholar 

  17. English JB, Westenskow D, Hodges MR, Stanley TH. Comparison of venous air embolism monitoring methods in supine dogs. Anesthesiology 1978;48:425–429

    Article  PubMed  CAS  Google Scholar 

  18. Severinghaus JS, Stafford M, Bradley AF. tcPCO2 electrode design calibration and temperature gradient problems. Acta Anaesth Scand 1978;68:118–122

    CAS  Google Scholar 

  19. Schieber RA, Namnoum A, Sugden A, et al. Accuracy of expiratory carbon dioxide measurements using the coaxial and circle breathing circuits in small subjects. J Clin Monit 1985;1:149–155

    Article  PubMed  CAS  Google Scholar 

  20. Sasse FJ. Can we trust end-tidal carbon dioxide measurements in infants? J Clin Monit 1985;1:147–148

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

The authors thank June Zaccari for technical assistance and Virginia Marana for manuscript preparation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Phan, C.Q., Tremper, K.K., Lee, S.E. et al. Noninvasive monitoring of carbon dioxide: A comparison of the partial pressure of transcutaneous and end-tidal carbon dioxide with the partial pressure of arterial carbon dioxide. J Clin Monitor Comput 3, 149–154 (1987). https://doi.org/10.1007/BF01695936

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01695936

Key Words

Navigation