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Assessment of blood gas status is important in the management of patients with chronic pulmonary disease. Arterial puncture is often painful and may damage the arterial wall. Measurement of oxygen saturation by transcutaneous oximetry offers a non-invasive alternative to arterial methods but does not allow assessment of partial pressure of carbon dioxide. We have examined the value of oximetry and dorsal hand venous carbon dioxide as an alternative to arterial puncture. Transcutaneous oxygen saturation correlated with arterial oxygen saturation (r = 0.76, p less than 0.001) with an error of 2.1% and dorsal hand venous carbon dioxide tension correlated with the arterial tension (r = 0.84, p less than 0.001) with an error of 8%. Changes in oximetric oxygen saturation and venous carbon dioxide tension following oxygen therapy reflected arterial values. Assessment of blood gas status using oximetry and dorsal hand venous carbon dioxide tension is a useful alternative to arterial puncture.