Fife CE, Smart DR, Sheffield PJ, Hopf HW, Hawkins G, Clarke D, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, In.... Date of publication 2009 Jan 1;volume 36(1):43-53.
1. Undersea Hyperb Med. 2009 Jan-Feb;36(1):43-53.
Transcutaneous oximetry in clinical practice: consensus statements from an expert
panel based on evidence.
Fife CE(1), Smart DR, Sheffield PJ, Hopf HW, Hawkins G, Clarke D.
Author information:
(1)Department of Medicine, Division of Cardiology, University of Texas Health
Science Center Houston, TX 77030, USA.
Transcutaneous oximetry (PtcO2) is finding increasing application as a diagnostic
tool to assess the peri-wound oxygen tension of wounds, ulcers, and skin flaps.
It must be remembered that PtcO2 measures the oxygen partial pressure in adjacent
areas of a wound and does not represent the actual partial pressure of oxygen
within the wound, which is extremely difficult to perform. To provide clinical
practice guidelines, an expert panel was convened with participants drawn from
the transcutaneous oximetry workshop held on June 13, 2007, in Maui, Hawaii.
Important consensus statements were (a) tissue hypoxia is defined as a PtcO2 <40
mm Hg; (b) in patients without vascular disease, PtcO2 values on the extremity
increase to a value >100 mm Hg when breathing 100% oxygen under normobaric
pressures; (c) patients with critical limb ischemia (ankle systolic pressure of <
or =50 mm Hg or toe systolic pressure of < or =30 mm Hg) breathing air will
usually have a PtcO2 <30 mm Hg; (d) low PtcO2 values obtained while breathing
normobaric air can be caused by a diffusion barrier; (e) a PtcO2 <40 mm Hg
obtained while breathing normobaric air is associated with a reduced likelihood
of amputation healing; (f) if the baseline PtcO2 increases <10 mm Hg while
breathing 100% normobaric oxygen, this is at least 68% accurate in predicting
failure of healing post-amputation; (g) an increase in PtcO2 to >40 mm Hg during
normobaric air breathing after revascularization is usually associated with
subsequent healing, although the increase in PtcO2 may be delayed; (h) PtcO2
obtained while breathing normobaric air can assist in identifying which patients
will not heal spontaneously.
PMID: 19341127 [Indexed for MEDLINE]
