Comparison of arterial, end-tidal and transcutaneous PCO2 during moderate exercise and external CO2 loading in humans

Static relationships between arterial, transcutaneous and end-tidal PCO2 (PaCO2, PtcCO2, PetCO2) as well as the dynamic relationship between PetCO2 and PtcCO2 were studied during moderate bicycle ergometer exercise with and without external CO2 loading. The exercise pattern consisted of 5-min intervals of constant power at 40 W and 100 W and 900 s of randomised changes between these two power levels. The external CO2 loading was achieved by means of controlled variations of inspiratory gas compositions aimed at a constant PetCO2 of 6.5 kPa (49 mm Hg). The PetO2 was regulated at 17.3 kPa (130 mm Hg). Under steady-state conditions all PCO2 parameters showed close linear relationships. PaCO2/PtcCO2 was near to identity while the PetCO2 systematically overestimated changes in PaCO2l No relationship showed a significant influence of the exercise intensity. Transients of PtcCO2 are considerably slower than PetCO2 transients. The dynamic relationship between both parameters was found to be independent of whether internal or external CO2 loadings were applied. It is concluded that the combination of PetCO2 and PtcCO2 measurements allows an improved non-invasive assessment of PaCO2. While PetCO2 better reflects the transients, PtcCO2 can be employed to determine slow changes of the absolute PaCO2.