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Transcutaneous oxygen - tcpO2

Transcutaneous oxygen (tcpO2/TCOM) measures the local Oxygen released from the skin through the capillaries, reflecting the metabolic state of the lower limb. It is particularly useful for wound healing prediction, amputation level determination and qualification for hyperbaric oxygen therapy.

TcpO2 provides instant, continuous information about the body’s ability to deliver oxygen to the tissue. TcpO2 is dependent on oxygen uptake in the respiratory system, the oxygen transport/capacity of the blood and the general status of the circulatory system. Any impairment of the organism's ability to deliver oxygen to the tissue will be revealed immediately since the skin is ranked very low in the body's system of oxygenation priority.

Technically, the electrode heats the underlying tissue to create a local hyperaemia, which intensifies the blood perfusion, increasing the oxygen pressure. In addition, the heat will dissolve the lipid structure of the dead, keratinized cells in the epidermal layer making the skin permeable to gas diffusion. On its way the oxygen may be consumed by the cells if the metabolism is high.

Note that transcutaneous oxygen is not the same as the arterial oxygen pressure measured using standard pulse oximeters.

Clinical applications:

Transcutaneous monitoring of oxygen and carbon dioxide, originally developed for neonatal use, has become a routine measurement in several clinical areas including:

  • Determination of peripheral vascular oxygenation
  • Quantification of the degree of peripheral vascular disease
  • Determination of the optimum level of amputation
  • Evaluation of revascularization procedures
  • Selecting candidates for hyperbaric oxygen therapy and predicting non-responders to treatment

TcpO2 measurements usually require at least two or three sites to provide a good picture. The more sites assessed, the better the oxygenation picture.

Interpreting data

Data is not always perfect.  Useful information to aid in the interpretation of results.

Each patient is unique

"Why does it take 15 minutes to get a stable baseline recording with tcpO2?” The answer is "physiology” and not solely technology. The electrode heats the underlying tissue to create a local hyperaemia. Each patient is unique and, depending on their vascular status, the time to achieve a stable baseline will differ. As seen in the examples, one patient may show stabilized values already after 8 minutes, while another patient might require 15 minutes.

Best practice is to run 10 - 15 minutes on all patients. Examine the graph and verify that it is stable. If the curve is stable, end the recording and, on the contrary, if the values are still decreasing or increasing, extend the run. In the Perimed tcpO2 software, it is always possible to view a graph, end a recording in advance or extend a run.

Maintenance

Regular cleaning and remembraning of electrodes is important. This is summarized in the below documents together with some other basic maintenance.

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Improving quality of life since 1981

Perimed AB, established in 1981, provides instruments, software and expertise to enable assessment of the microcirculation. We utilize laser Doppler, laser speckle (LASCA) and transcutaneous oxygen (tcpO2 or TCOM), to accurately monitor and quantify blood perfusion and tissue oxygenation in real-time. Our modular PeriFlux System 5000 and PeriFlux 6000, the latest generation of our PeriFlux System, are excellent choices for diagnosing Peripheral Arterial Disease (PAD) and Critical Limb Ischemia (CLI) or for assessing wound healing potential in your vascular patients. Our blood perfusion imagers PeriScan PIM 3 System and PeriCam PSI System, allow you to investigate spatial distribution, for example during cortical spreading depression.