Academic Journal
View in EDS

Validity of transcutaneous capnometry in prolonged use in a patient population with acute respiratory failure.

Bibliographic Details
Title: Validity of transcutaneous capnometry in prolonged use in a patient population with acute respiratory failure.
Authors: Kächele M; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. Electronic address: martin.kaechele@uniklinik-ulm.de., Hasmüller M; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany., Kalner A; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany., Seufferlein T; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany., Müller M; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany; Western Allgaeu Hospital Wangen, Am Engelberg 29, Wangen im Allgäu, 88239, Germany.
Source: Respiratory medicine [Respir Med] 2026 Sep; Vol. 261, pp. 109072. Date of Electronic Publication: 2026 Jul 31.
Publication Type: Journal Article; Validation Study
Language: English
Journal Info: Publisher: Elsevier Country of Publication: England NLM ID: 8908438 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-3064 (Electronic) Linking ISSN: 09546111 NLM ISO Abbreviation: Respir Med Subsets: MEDLINE
Imprint Name(s): Publication: 2003- : Oxford : Elsevier
Original Publication: London : Baillière Tindall, in association with the British Thoracic Society, [c1989-
MeSH Terms: Blood Gas Monitoring, Transcutaneous*/methods , Blood Gas Monitoring, Transcutaneous*/instrumentation , Respiratory Insufficiency*/blood , Respiratory Insufficiency*/diagnosis, Carbon Dioxide/blood ; Blood Gas Analysis/methods ; Monitoring, Physiologic/methods ; Humans ; Female ; Male ; Middle Aged ; Aged ; Acute Disease ; Reproducibility of Results ; Adult ; Critical Illness ; Aged, 80 and over ; Feasibility Studies
Abstract: Background: Transcutaneous capnometry is a widespread method for monitoring carbon dioxide in respiratory care. Studies on its use in emergency medicine, the sensors long-term stability its practicability in this setting are lacking. This study aimed to clarify whether transcutaneous capnometry is a valid and feasible method for monitoring critically ill patients.
Methods: 100 patients with acute respiratory failure were monitored simultaneously with arterial blood gas analysis (paCO2) and transcutaneous capnometry (tcpCO2), using Radiometer TCM5, at baseline (T1) and after a maximum of 12 h (T2) an analyzed regarding clinically acceptable concordance and interruptions.
Results: Ninety-three patients (176 paired samples of paCO2 and tcpCO2) were included in the analysis. We found a good correlation between pCO2 and tcpCO2 (r = 0.9706) at T1, which weakened at T2 (r = 0.7760). However, the difference in the concordance of the measured values at T1 and T2 was not significantly different (p = 0.0545). Significantly frequent deviations between T1 and T2 occurred in patients with circulatory impairment (p = 0.0039). 22.9% of all values were outside the clinically acceptable range, but with paCO2 underestimated by tcpCO2 in only 5 cases (2.8%). In all clinically relevant deviations, we found an underlying technical error which would have been found by a trained examiner.
Conclusions: Transcutaneous capnometry is a feasible method for monitoring CO2 trends. However, its successful application requires thorough knowledge of the analysis technique and potential sources of error. The validity of the method is limited in patients with significant circulatory dysregulation. Additionally, long-term use in clinical practice is often restricted by suboptimal patient conditions.
(Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Declaration of competing interest All authors declare no conflicts of interest.
Contributed Indexing: Keywords: Acute respiratory failure; Capnometry; Hypercapnia; Transcutaneous carbon dioxide monitoring
Substance Nomenclature: 142M471B3J (Carbon Dioxide)
Entry Date(s): Date Created: 20260731 Date Completed: 20260812 Latest Revision: 20260812
Update Code: 20260813
DOI: 10.1016/j.rmed.2026.109072
PMID: 42537816
Database: MEDLINE
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://www.doi.org/10.1016/j.rmed.2026.109072?
    Name: ScienceDirect (all content) (s7799221)
    Category: fullText
    Text: View record from ScienceDirect
    MouseOverText: View record from ScienceDirect
  – Url: https://resolver.ebsco.com/c/fiv2js/result?sid=EBSCO:cmedm&genre=article&issn=15323064&ISBN=&volume=261&issue=&date=20260901&spage=109072&pages=109072&title=Respiratory medicine&atitle=Validity%20of%20transcutaneous%20capnometry%20in%20prolonged%20use%20in%20a%20patient%20population%20with%20acute%20respiratory%20failure.&aulast=K%C3%A4chele%20M&id=DOI:10.1016/j.rmed.2026.109072
    Name: Full Text Finder (for New FTF UI) (ns324271)
    Category: fullText
    Text: Full Text Finder
    MouseOverText: Full Text Finder
Header DbId: cmedm
DbLabel: MEDLINE
An: 42537816
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Validity of transcutaneous capnometry in prolonged use in a patient population with acute respiratory failure.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AU" term="%22Kächele+M%22">Kächele M</searchLink>; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany. Electronic address: martin.kaechele@uniklinik-ulm.de.<br /><searchLink fieldCode="AU" term="%22Hasmüller+M%22">Hasmüller M</searchLink>; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany.<br /><searchLink fieldCode="AU" term="%22Kalner+A%22">Kalner A</searchLink>; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany.<br /><searchLink fieldCode="AU" term="%22Seufferlein+T%22">Seufferlein T</searchLink>; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany.<br /><searchLink fieldCode="AU" term="%22Müller+M%22">Müller M</searchLink>; Clinic for Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany; Western Allgaeu Hospital Wangen, Am Engelberg 29, Wangen im Allgäu, 88239, Germany.
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%228908438%22">Respiratory medicine</searchLink> [Respir Med] 2026 Sep; Vol. 261, pp. 109072. <i>Date of Electronic Publication: </i>2026 Jul 31.
– Name: TypePub
  Label: Publication Type
  Group: TypPub
  Data: Journal Article; Validation Study
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: TitleSource
  Label: Journal Info
  Group: Src
  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Elsevier%22">Elsevier </searchLink><i>Country of Publication: </i>England <i>NLM ID: </i>8908438 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1532-3064 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2209546111%22">09546111 </searchLink><i>NLM ISO Abbreviation: </i>Respir Med <i>Subsets: </i>MEDLINE
– Name: PublisherInfo
  Label: Imprint Name(s)
  Group: PubInfo
  Data: <i>Publication</i>: 2003- : Oxford : Elsevier<br /><i>Original Publication</i>: London : Baillière Tindall, in association with the British Thoracic Society, [c1989-
– Name: SubjectMESH
  Label: MeSH Terms
  Group: Su
  Data: <searchLink fieldCode="MM" term="%22Blood+Gas+Monitoring%2C+Transcutaneous%22">Blood Gas Monitoring, Transcutaneous*</searchLink>/<searchLink fieldCode="MM" term="%22Blood+Gas+Monitoring%2C+Transcutaneous+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Blood+Gas+Monitoring%2C+Transcutaneous%22">Blood Gas Monitoring, Transcutaneous*</searchLink>/<searchLink fieldCode="MM" term="%22Blood+Gas+Monitoring%2C+Transcutaneous+instrumentation%22">instrumentation</searchLink> <br /><searchLink fieldCode="MM" term="%22Respiratory+Insufficiency%22">Respiratory Insufficiency*</searchLink>/<searchLink fieldCode="MM" term="%22Respiratory+Insufficiency+blood%22">blood</searchLink> <br /><searchLink fieldCode="MM" term="%22Respiratory+Insufficiency%22">Respiratory Insufficiency*</searchLink>/<searchLink fieldCode="MM" term="%22Respiratory+Insufficiency+diagnosis%22">diagnosis</searchLink><br /><searchLink fieldCode="MH" term="%22Carbon+Dioxide%22">Carbon Dioxide</searchLink>/<searchLink fieldCode="MH" term="%22Carbon+Dioxide+blood%22">blood</searchLink> ; <searchLink fieldCode="MH" term="%22Blood+Gas+Analysis%22">Blood Gas Analysis</searchLink>/<searchLink fieldCode="MH" term="%22Blood+Gas+Analysis+methods%22">methods</searchLink> ; <searchLink fieldCode="MH" term="%22Monitoring%2C+Physiologic%22">Monitoring, Physiologic</searchLink>/<searchLink fieldCode="MH" term="%22Monitoring%2C+Physiologic+methods%22">methods</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Acute+Disease%22">Acute Disease</searchLink> ; <searchLink fieldCode="MH" term="%22Reproducibility+of+Results%22">Reproducibility of Results</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Critical+Illness%22">Critical Illness</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%2C+80+and+over%22">Aged, 80 and over</searchLink> ; <searchLink fieldCode="MH" term="%22Feasibility+Studies%22">Feasibility Studies</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Transcutaneous capnometry is a widespread method for monitoring carbon dioxide in respiratory care. Studies on its use in emergency medicine, the sensors long-term stability its practicability in this setting are lacking. This study aimed to clarify whether transcutaneous capnometry is a valid and feasible method for monitoring critically ill patients.<br />Methods: 100 patients with acute respiratory failure were monitored simultaneously with arterial blood gas analysis (paCO2) and transcutaneous capnometry (tcpCO2), using Radiometer TCM5, at baseline (T1) and after a maximum of 12 h (T2) an analyzed regarding clinically acceptable concordance and interruptions.<br />Results: Ninety-three patients (176 paired samples of paCO2 and tcpCO2) were included in the analysis. We found a good correlation between pCO2 and tcpCO2 (r = 0.9706) at T1, which weakened at T2 (r = 0.7760). However, the difference in the concordance of the measured values at T1 and T2 was not significantly different (p = 0.0545). Significantly frequent deviations between T1 and T2 occurred in patients with circulatory impairment (p = 0.0039). 22.9% of all values were outside the clinically acceptable range, but with paCO2 underestimated by tcpCO2 in only 5 cases (2.8%). In all clinically relevant deviations, we found an underlying technical error which would have been found by a trained examiner.<br />Conclusions: Transcutaneous capnometry is a feasible method for monitoring CO<subscript>2</subscript> trends. However, its successful application requires thorough knowledge of the analysis technique and potential sources of error. The validity of the method is limited in patients with significant circulatory dysregulation. Additionally, long-term use in clinical practice is often restricted by suboptimal patient conditions.<br /> (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declaration of competing interest All authors declare no conflicts of interest.
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: <i>Keywords: </i>Acute respiratory failure; Capnometry; Hypercapnia; Transcutaneous carbon dioxide monitoring
– Name: NumberCAS
  Label: Substance Nomenclature
  Group: ID
  Data: 142M471B3J (Carbon Dioxide)
– Name: DateEntry
  Label: Entry Date(s)
  Group: Date
  Data: <i>Date Created: </i>20260731 <i>Date Completed: </i>20260812 <i>Latest Revision: </i>20260812
– Name: DateUpdate
  Label: Update Code
  Group: Date
  Data: 20260813
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1016/j.rmed.2026.109072
– Name: AN
  Label: PMID
  Group: ID
  Data: 42537816
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42537816
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.rmed.2026.109072
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 109072
    Subjects:
      – SubjectFull: Carbon Dioxide blood
        Type: general
      – SubjectFull: Blood Gas Analysis methods
        Type: general
      – SubjectFull: Monitoring, Physiologic methods
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Acute Disease
        Type: general
      – SubjectFull: Reproducibility of Results
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Critical Illness
        Type: general
      – SubjectFull: Aged, 80 and over
        Type: general
      – SubjectFull: Feasibility Studies
        Type: general
      – SubjectFull: Blood Gas Monitoring, Transcutaneous methods
        Type: general
      – SubjectFull: Blood Gas Monitoring, Transcutaneous instrumentation
        Type: general
      – SubjectFull: Respiratory Insufficiency blood
        Type: general
      – SubjectFull: Respiratory Insufficiency diagnosis
        Type: general
    Titles:
      – TitleFull: Validity of transcutaneous capnometry in prolonged use in a patient population with acute respiratory failure.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Kächele M
      – PersonEntity:
          Name:
            NameFull: Hasmüller M
      – PersonEntity:
          Name:
            NameFull: Kalner A
      – PersonEntity:
          Name:
            NameFull: Seufferlein T
      – PersonEntity:
          Name:
            NameFull: Müller M
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Text: 2026 Sep
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1532-3064
          Numbering:
            – Type: volume
              Value: 261
          Titles:
            – TitleFull: Respiratory medicine
              Type: main
ResultId 1