Tissue CO2 Clinical References

The following peer-reviewed scientific literature discusses the potential clinical
use of oral mucosal tissue pCO2 measurement and monitoring.

Bar, et al Regional capnometry to evaluate the adequacy of tissue perfusion. J Thorac Dis. 2019; 11(Suppl 11):S1568-S1573.

Baron, et al Diagnostic utility of sublingual PCO2 for detecting hemorrhage in penetrating trauma patients. J Trauma. 2004;57(1):69-74.

Baron, et al Sublingual Capnometry for Rapid Determination of the Severity of Hemorrhagic Shock. Journal of Trauma. 2007; 62:120-124

Cammarata, et al Buccal capnometry to guide management of massive blood loss. J Appl Physiol. 2006; 100:304-6.

Cammarata, et al Buccal capnometry for quantitating the severity of hemorrhagic shock. Shock. 2009; 31(2):207-11.

Creteur Gastric and sublingual capnometry. Curr Opin Crit Care. 2006; 12(3):272-7.

Creteur, et al Sublingual capnometry tracks microcirculatory changes in septic patients. Intensive Care Med. 2006; 32:516-23.

De Backer, et al Microvascular blood flow in altered in patients with sepsis. Am J Respir Crit Care Med. 2002; 166:98-104.

Fries, et al Increases in tissue PCO2 during circulatory shock reflect selective decreases in capillary blood flow. Crit Care Med. 2006; 34:446-452.

Jin, et al Decreases in organ blood flows associated with increases in sublingual PCO2 during hemorrhagic shock. J Appl Physiol. 1998; 85:2360–2364.

Jones, et al Sepsis-Induced Tissue Hypoperfusion. Crit Care Clin 25 (2009): 169-779

Maciel, et al Tissue capnometry: does the answer lie under the tongue? Intensive Care Med. 2004; 30:2157–2165.

Mallet, et al Mucosal and cutaneous capnometry for the assessment of tissue hypoperfusion. Minerva Anestesiologica. 2018; 84(1):68-80.

Marik Sublingual capnography: a clinical validation study. Chest. 2001; 120:923–927.

Marik Regional carbon dioxide monitoring to assess the adequacy of tissue perfusion. Curr Opin Crit Care. 2005; 11:245.

Marik Sublingual capnometry: a non-invasive measure of microcirculatory dysfunction and tissue hypoxia. Physiol Meas. 2006; 27(7):R37-47.

Marik, et al Sublingual capnometry versus traditional markers of tissue oxygenation in critically ill patients. Crit Care Med. 2003; 31:818–822.

Nakagawa, et al Sublingual capnometry for diagnosis and quantitation of circulatory shock. Am J Respir Crit Care Med. 1998; 157:1838–1843.

Pellis, et al Increases in both buccal and sublingual PCO2 reflect decreases in tissue blood flows in a porcine model during hemorrhagic shock. J Trauma. 2005; 58:817–824.

Pernat, et al Effect of hyper- and hypoventilation on gastric and sublingual PCO2. J Appl Physiol. 1999;87: 933–937.

Pinsky Both perfusion pressure and flow are essential for adequate resuscitation. Sepsis. 2001 4,(2): 143-146.

Povoas, et al Comparisons Between Sublingual and Gastric Tonometry During Hemorrhagic Shock. Chest. 2000; 118:1127-3

Povoas, et al Decreases in mesenteric blood flow associated with increases in sublingual PCO2 during hemorrhagic shock. Shock. 2001; 15:398–402.

Rackow, et al Sublingual Capnometry and Indexes of Tissue Perfusion in Patients With Circulatory Failure. Chest. 2001; 120:1633-8.

Sakr, et al Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit Care Med. 2004; 32:1825–1831.

Sato, et al PCO2 as a monitor of perfusion failure during hemorrhagic shock. J Appl Physiol. 1997; 82:558–562

Sproesser, et al Capnometry for Diagnosing and Monitoring Cardiopulmonary Crises. Resident & Staff Physician. 2000; 46:17-27

Tang, et al Gastric intramucosal PCO2 as monitor of perfusion failure during hemorrhagic shock and anaphylactic shock. J Appl Physiol. 1994; 76:572–577

Weil, Tissue PC02 as Universal Marker of Tissue Hypoxia. Minerva Anestesiologica. 2000; 66:343-7

Weil, et al Sublingual capnometry: a new noninvasive measurement for diagnosis and quantitation of severity of circulatory shock. Crit Care Med. 1999; 27:1225–1229

Xu, et al Fluid resuscitation guided by partial pressure of carbon dioxide during hemorrhagic shock in a porcine model. Shock. 2013;39(4):361-5

Yee, et al Sublingual Capnometry: In Search of its Holy Grail. CHEST. 2000; TI8:894-96