Historical Perspectives

Abstract

This month’s Historical Perspective draws attention to the remarkable feat achieved by Renate and Albert Huch in the early 1970s, which seemed magical at the time. This was the development of an electrode that measured the partial pressure of oxygen at the skin surface (tcPo2), which reflected the oxygen tension in arterial blood. (1) Subsequently, continuous transcutaneous measurement demonstrated that intermittent arterial blood gas measurements provided only a glimpse of the dynamic variations that occur with different procedures in the neonatal intensive care unit (NICU). In addition, it was not long before the use of two electrodes demonstrated shunting through the ductus arteriosus. (2) Later in the same decade, this same team produced a complementary electrode to measure the partial pressure of carbon dioxide (tcPco2). (3) The measurement of both tcPo2 and tcPco2 allowed greatly improved management of assisted ventilation. There was one significant disadvantage of tcPo2 monitoring, which was the need to move the electrode every few hours to prevent skin injury from the heating device. As a result, when pulse oximetry became available, monitoring of oxygen saturation became more popular. However, as the Huchs point out, most pulse oximeters have a problem with movement artefact (although this may have been resolved with some devices), and they cannot detect hyperoxemia. Consequently, transcutaneous blood gas monitoring (particularly tcPco2) remains an important adjunct in the NICU, especially early in the course of respiratory disease. 1. ↵ Huch R, Huch A, Lubbers DW. Transcutaneous measurement of blood PO2 (tcPO2): method and applications in perinatal medicine. J Perinat Med. 1973;1:183–191 [OpenUrl][1][PubMed][2] 2. ↵ Yamanouchi I, Igarashi I. Ductal shunt in premature infants observed by tcPO2 measurements. In: Huch A, Huch R, Lucey JF, eds. Transcutaneous Blood Gas Monitoring. Birth Defects: Original Article Series. Vol. 15. New York, NY: AR Liss;1979 :323–340 3. ↵ Huch A, Huch R, Seiler D, Galster H, Meinzer K, Lubbers DW. Transcutaneous PCO2 measurement with a miniaturized electrode. Lancet. 1977;i:982–983 [OpenUrl][3] # Transcutaneous Po2 in Newborns: An Electrode in the Family {#article-title-2} When we met in the German university city of Gottingen in 1959, Albert was a medical student and Renate was still in high school. After qualifying, Albert studied respiratory physiology at the Max Planck Institute for Experimental Medicine in Gottingen while Renate completed her medical studies. We married in 1964 and moved some miles south to Marburg, another medieval university … [1]: {openurl}?query=rft.jtitle%253DJournal%2Bof%2Bperinatal%2Bmedicine%26rft.stitle%253DJ%2BPerinat%2BMed%26rft.aulast%253DHuch%26rft.auinit1%253DR.%26rft.volume%253D1%26rft.issue%253D3%26rft.spage%253D183%26rft.epage%253D191%26rft.atitle%253DTranscutaneous%2Bmeasurement%2Bof%2Bblood%2BPo2%2B%2528tcPo2%2529%2B--%2BMethod%2Band%2Bapplication%2Bin%2Bperinatal%2Bmedicine.%26rft_id%253Dinfo%253Apmid%252F4806572%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=4806572&link_type=MED&atom=%2Fneoreviews%2F4%2F9%2Fe223.atom [3]: {openurl}?query=rft.jtitle%253DLancet.%26rft.volume%253D0%26rft.spage%253D982%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx