Vasomotor effects of transcutaneous CO2 in stage II peripheral occlusive arterial disease

Vasomotor effects of skin exposure to carbon dioxide (CO2) have been described in normal subjects. It was of interest, therefore, to determine whether percutaneous CO2 is of therapeutic benefit. In a randomized, double-blind study, 10 patients with lower limb arteriopathy (stage II) were investigated before and after local exposure for twenty minutes to CO2-rich spa gas or to water-vapor-saturated air at the same temperature as that CO2-rich spa gas. Brachial and femoral blood flows, brachial and posterior tibial artery pressures, heart rate, and chest and foot transcutaneous oxygen tensions (tcPO2) were determined. Femoral blood flow, tibial pressure, and foot tcPO2 were significantly increased after exposure of the skin to CO2-rich spa gas. This effect was not accompanied with systemic hemodynamic modifications. Water-vapor-saturated air had no effect. These results suggest that transfer of CO2 across the skin can have beneficial local vasomotor effects in patients with lower limb stage II arteriopathy.