Transcutaneous oximetry measurement: normal values for the upper limb.
Derelle L Young1, Denise F Blake, Lawrence H Brown
1The Townsville Hospital, Townsville, Queensland, Australia. Derelle_Young@health.qld.gov.au
Diving and Hyperbaric Medicine
|December 22, 2012
Summary
Establishing normal transcutaneous oximetry (TCOM) values for the upper limb is crucial. This study provides these reference values, highlighting that lower limb standards may lead to misdiagnosis of upper limb tissue hypoxia.
Area of Science:
- Medical Devices
- Physiology
- Diagnostic Tools
Background:
- Existing transcutaneous oximetry (TCOM) reference values are established for the chest and lower limb.
- Standardized healthy-subject reference values for upper limb TCOM are lacking.
- Meaningful interpretation of upper limb TCOM in disease or injury requires established normal values.
Purpose of the Study:
- To determine normal transcutaneous oximetry (TCOM) values for the upper limb in healthy, non-smoking adults.
- To establish reliable reference ranges for upper limb TCOM measurements.
- To inform the accurate interpretation of TCOM in clinical settings involving upper limb conditions.
Main Methods:
- Thirty-two healthy volunteers (16 male, 16 female) participated in the study.
- Transcutaneous oximetry (TCOM) was performed on the chest and five upper limb sites (upper arm, forearm, dorsum of hand, thenar, and hypothenar eminences).
- Measurements were recorded using the TCM400 Monitoring System under both room air and 100% oxygen breathing conditions.
Main Results:
- Normal room-air TCOM values were established for various upper limb locations.
- Upper limb TCOM readings were significantly lower than established lower limb values.
- Applying lower limb thresholds (< 40 mmHg) to upper limb data could incorrectly identify tissue hypoxia in healthy individuals.
Conclusions:
- Normal upper limb transcutaneous oximetry (TCOM) values are lower than those for the lower limb.
- Utilizing lower limb TCOM standards may lead to false-positive diagnoses of tissue hypoxia in the upper limb.
- Recommended thresholds for upper limb tissue hypoxia are ≤ 30 mmHg for the upper arm, thenar, and hypothenar eminences, and < 20 mmHg for the forearm and dorsum of the hand.
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