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Reference Probe for TcpO2 at Rest: A Systematic Review.

Judith Catella1,2,3,4, Guillaume Mahé5,6, Georges Leftheriotis7

  • 1Service de Médecine Interne et Vasculaire, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France.

Diagnostics (Basel, Switzerland)
|January 8, 2023
PubMed
Summary

The relevance of a reference probe for transcutaneous oxygen pressure (TcpO2) in lower extremity arterial disease (LEAD) is unclear. Limited evidence supports its use for predicting amputation healing, with more research needed.

Keywords:
TcpO2peripheral arterial diseasereference proberegional perfusion index

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Area of Science:

  • Vascular Medicine
  • Medical Devices
  • Diagnostic Techniques

Background:

  • Transcutaneous oxygen pressure (TcpO2) is crucial for assessing lower extremity arterial disease (LEAD) severity.
  • The use of a regional perfusion index (RPI), a ratio of limb to chest TcpO2, is debated for its independence from oxygen delivery variations.
  • The necessity and impact of a reference probe's position for TcpO2 measurements in LEAD remain under investigation.

Purpose of the Study:

  • To systematically review the existing literature on the relevance of reference probes in TcpO2 measurements for LEAD.
  • To evaluate the utility of TcpO2 and RPI in predicting outcomes related to LEAD.
  • To determine if TcpO2 reference probes offer significant advantages over absolute TcpO2 measurements in resting conditions.

Main Methods:

  • A comprehensive literature search was conducted on Medline and the Cochrane Central Register of Controlled Trials.
  • Keywords included TcpO2, reference probe, and lower extremity arterial disease (LEAD).
  • Fifteen relevant studies were identified and included in the review.

Main Results:

  • Nine studies focused on LEAD severity, amputation healing, surgical outcomes, or therapeutic effects.
  • Out of 12 studies using RPI, only two reported a benefit over absolute TcpO2.
  • One study showed RPI predicted limb viability, while another found both RPI and absolute TcpO2 were prognostic factors.

Conclusions:

  • Current evidence is insufficient to support the routine use of TcpO2 reference probes for most LEAD indications at rest.
  • One study suggests RPI may predict below-knee amputation healing, but requires prospective validation.
  • Further research is needed to clarify the role and benefits of reference probes in TcpO2 assessment for LEAD.