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Updated: Jun 25, 2026

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Evaluation of transcutaneous CO2 responses following acute changes in PaCO2 in healthy subjects
Satoshi Fuke1, Kenji Miyamoto, Hiroshi Ohira
1First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Background And Objective:
Transcutaneous blood gas-monitoring systems with miniaturized SpO(2) (peripheral blood oxygen saturation)/PCO(2) combined sensors (TOSCATM) have been widely used. There are no reports of the inter- and intra-individual variability in transcutaneous measurements of PaCO(2) (PtcCO(2)) in response to acute progressive changes in PaCO(2). This study examined inter- and intra-individual variability of PtcCO(2) measurements under semi-steady-state conditions, and characterized the behaviour of PtcCO(2) in response to acute progressive changes in PaCO(2).
Methods:
Subjects breathed mixed gases through a mouthpiece connected to an automatic arterial blood gas controller. Using end-tidal PCO(2) and PO(2) as guides, PaCO(2) was controlled to increase and/or decrease between baseline and > or = 60 mm Hg, in a stepwise (n = 9) or progressive fashion (n = 6). Arterial blood was sampled when needed.
Results:
Intra-individual correlation coefficients between PtcCO(2) and PaCO(2) were excellent in all subjects (0.971-0.989); however, the slope of the regression line varied among subjects (1.040-1.335). Bias and limits of agreement (+/- 2 SD from bias) between PtcCO(2) and PaCO(2) were -1.8 mm Hg and -7.7 to 4.1 mm Hg. Changes in PtcCO(2) in response to acute progressive changes in PaCO(2) also varied among subjects.
Conclusion:
The PtcCO(2) measurement system allows reliable estimation of PaCO(2) in a given subject. However, caution is needed when comparing absolute values between subjects or when acute changes in PaCO(2) occur.
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