Diagnosis of major peripheral arterial trauma by transcutaneous oxygen monitoring.

During a 6 month period, 36 consecutive suspected major peripheral arterial injuries in 33 patients were evaluated by clinical examination and Doppler signal. Thirty-three of these injuries were also evaluated using portable transcutaneous oxygen monitors. Of the 12 confirmed arterial injuries, 2 had normal Doppler-derived blood pressures and significantly decreased transcutaneous oxygen tensions. The transcutaneous oxygen values in traumatized limbs with arterial injury were significantly lower than in traumatized limbs without arterial injury (34 +/- 6 versus 58 +/- 3, p less than 0.01). The ratio of the injured limb transcutaneous oxygen tension to the uninjured contralateral limb transcutaneous oxygen tension was also significantly lower in the group with arterial injury than in the group without arterial injury (0.72 +/- 0.08 versus 1.12 +/- 0.05, p less than 0.01). The overall sensitivity and specificity of the diagnosis of major peripheral arterial injury by a bilateral transcutaneous oxygen ratio less than 0.90 was 80 percent and 91 percent, respectively. In addition, transcutaneous oxygen monitoring helped quantify tissue perfusion in limbs with decreased neurologic function and Doppler-derived blood pressure. The results suggest that transcutaneous oxygen monitoring is a valuable, noninvasive adjunctive method for the diagnosis of major peripheral arterial trauma.