Transcutaneous Carbon Dioxide Monitoring in Critical Care

Transcutaneous carbon dioxide monitoring offers a continuous, non-invasive assessment of a patient’s ventilatory status by measuring the partial pressure of carbon dioxide (PCO₂) at the skin surface. By heating a small electrode to enhance capillary blood flow, these devices infer arterial CO₂ levels without repeated blood sampling. In critical care settings, where rapid fluctuations in ventilation demand prompt intervention, transcutaneous readings enable real-time trend analysis, guiding ventilator adjustments and reducing the frequency of arterial blood gas analyses. This approach is particularly valuable in neonates and paediatric patients with limited blood volume, in sedated or paralyse­d adults under mechanical ventilation, and during procedures that interrupt conventional sampling. Despite advances in sensor design, challenges remain regarding measurement lag time, calibration drift, and skin integrity under prolonged heating. Recent technical refinements have sought to minimise these issues, improving accuracy and patient comfort. Globally, transcutaneous CO₂ monitoring is gaining recognition as a complementary tool that bridges gaps between intermittent invasive sampling and continuous capnography, enhancing safety and efficiency in intensive care units.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Transcutaneous Carbon Dioxide Monitoring in Critical Care publication trend

The graph below shows the total number of articles in transcutaneous carbon dioxide monitoring in critical care across all publications each year (not limited to Nature Index journals).

Technical terms

Transcutaneous carbon dioxide monitoring: non-invasive measurement of CO₂ partial pressure through heated skin sensors.

Arterial partial pressure of carbon dioxide (PaCO₂): the tension of CO₂ in arterial blood, obtained by blood gas analysis and regarded as the clinical reference for ventilation.

End-tidal carbon dioxide (etCO₂): concentration of CO₂ in exhaled breath at the end of expiration, measured via capnography.

Capnography: continuous recording of exhaled CO₂ over time, used to assess ventilation, perfusion and metabolic status.

References

1. The clinical application of transcutaneous carbon dioxide monitoring during rigid bronchoscopy or microlaryngeal surgery in children. Journal of Clinical Anesthesia (2024).
2. Enhancing the estimation of PaCO2 from etCO2 during ventilation through non-invasive parameters in the ovine model. BioMedical Engineering OnLine (2024).
3. Novel transcutaneous sensor combining optical tcPO2 and electrochemical tcPCO2 monitoring with reflectance pulse oximetry. Medical & Biological Engineering & Computing (2019).