Transcutaneous carbon dioxide monitoring as a valid complementary method in acute respiratory failure

Concise monitoring of patients suffering from acute respiratory failure is mandatory but highly labor-intensive and thus tying up personnel and organizational resources due to the requirement of repetitive arterial blood gas analyses (aBGA). More than anything the current Covid-19 crisis unveiled the real scarcity in staff resources and consequently shortage of surveillance capacity. Based on published data transcutaneous capnometry (TcCO2) is not suitable to fully replace aBGA. In line, a recently published article from Mummery et al . critically assesses value and reliability of TcCO2 in an emergency care unit, revealing that TcCO2 cannot concordantly detect very slight changes in arterial CO2 (PaCO2) values defined within the range from ±0.25 kPa (1.88 mmHg) [1]. However, there are strong indicators underpinning synergistic use in defined patient cohorts [2, 3]. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Perkhofer has nothing to disclose. Conflict of interest: Dr. Strobel has nothing to disclose. Conflict of interest: Dr. Gagiannis reports personal fees from Boehringer Ingelheim, personal fees from MSD, personal fees from Berlin Chemie, personal fees from Novartis, personal fees from AstraZeneca, personal fees from Roche, outside the submitted work. Conflict of interest: Dr. Seufferlein has nothing to disclose. Conflict of interest: Dr. Mayer has nothing to disclose. Conflict of interest: Prof. Kleger has nothing to disclose. Conflict of interest: Dr. Muller has nothing to disclose. Conflict of interest: Dr. Schmidt has nothing to disclose.