Mitochondrial Oxygen Monitoring During Surgical Repair of Congenital Diaphragmatic Hernia or Esophageal Atresia: A Feasibility Study

Costerus, Sophie A; Bettink, Mark Wefers; Tibboel, Dick; Mik, Egbert G.

doi:10.3389/fped.2020.00532

Cited by 6 publications

(5 citation statements)

References 49 publications

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“…Interestingly, an unexpected high incidence of adverse events was seen in our study, since 100% of the healthy volunteers developed local adverse events during the measurements. Previously reported incidence of adverse events of mitoPO 2 measurements was 45% in healthy volunteers [ 31 ], while minimal to no adverse events have been reported in mitoPO 2 measurements with critically ill patients [ 15 , 20 , 32 ]. As in previous studies, the adverse events were present at the measurement sites up to one month after the last mitoPO 2 measurement.…”

Section: Discussionmentioning

confidence: 99%

“…MitoPO 2 measurement at the anterior chest wall in supine position strengthened the stabilization of the measurement probe despite respiratory movements of the chest wall. A double-sided plaster for fixation of the measurement probe is now handed out by the manufacturer to further minimise the effect of movement artefacts of the measurement probe on measurement variability [ 14 , 32 ]. Despite no availability of double-sided plaster during the measurements in this study, the within-subject variability over time was within acceptable limits as described in previous studies [ 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Description of mitochondrial oxygen tension and its variability in healthy volunteers

Baysan,

Broere,

Wille

et al. 2024

PLoS ONE

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Objectives Describing mitochondrial oxygenation (mitoPO2) and its within- and between-subject variability over time after 5-aminolevulinic acid (ALA) plaster application in healthy volunteers. Design Prospective cohort study. Setting Measurements were performed in Leiden University Medical Center, the Netherlands. Participants Healthy volunteers enrolled from July to September 2020. Interventions Two ALA plasters were placed parasternal left and right, with a 3-hour time interval, to examine the influence of the calendar time on the value of mitoPO2. We measured mitoPO2 at 4, 5, 7, 10, 28, and 31 hours after ALA plaster 1 application, and at 4, 5, 7, 25, and 28 hours after ALA plaster 2 application. Primary and secondary outcome measures At each time point, five mitoPO2 measurements were performed. Within-subject variability was defined as the standard deviation (SD) of the mean of five measurements per timepoint of a study participant. The between-subject variability was the SD of the mean mitoPO2 value of the study population per timepoint. Results In 16 completed inclusions, median mitoPO2 values and within-subject variability were relatively similar over time at all time points for both plasters. An increase in overall between-subject variability was seen after 25 hours ALA plaster time (19.6 mm Hg vs 23.9 mm Hg after respectively 10 and 25 hours ALA plaster time). Conclusions The mitoPO2 values and within-subject variability remained relatively stable over time in healthy volunteers. An increase in between-subject variability was seen after 25 hours ALA plaster time warranting replacement of the ALA plaster one day after its application. Trial registration ClinicalTrials.gov with trial number NCT04626661.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Description of mitochondrial oxygen tension and its variability in healthy volunteers

Baysan,

Broere,

Wille

et al. 2024

PLoS ONE

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“…Further pre-clinical studies consisted of (calibration) studies in healthy volunteers, after which the focus shifted to clinical studies [20,26]. Since the introduction of the clinical COMET system in 2016, mitochondrial oxygenation has been analyzed in neonates and in neurosurgical, cardiothoracic surgery, COVID-19, and sepsis patients [27][28][29][30]. A depiction of the COMET system can be seen in Figure 2.…”

Section: Mitopo 2 Measurementsmentioning

confidence: 99%

Measuring Mitochondrial Oxygen Tension during Red Blood Cell Transfusion in Chronic Anemia Patients: A Pilot Study

et al. 2023

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In light of the associated risks, the question has been raised whether the decision to give a blood transfusion should solely be based on the hemoglobin level. As mitochondria are the final destination of oxygen transport, mitochondrial parameters are suggested to be of added value. The aims of this pilot study were to investigate the effect of a red blood cell transfusion on mitochondrial oxygenation as measured by the COMET device in chronic anemia patients and to explore the clinical usability of the COMET monitor in blood transfusion treatments, especially the feasibility of performing measurements in an outpatient setting. To correct the effect of volume load on mitochondrial oxygenation, a red blood cell transfusion and a saline infusion were given in random order. In total, 21 patients were included, and this resulted in 31 observations. If patients participated twice, the order of infusion was reversed. In both the measurements wherein a blood transfusion was given first and wherein 500 mL of 0.9% saline was given first, the median mitochondrial oxygen tension decreased after red blood cell transfusion. The results of this study have strengthened the need for further research into the effect of blood transfusion tissue oxygenation and the potential role of mitochondrial parameters herein.

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“…Since the introduction of COMET ® it has been utilized in several clinical studies. To date, the COMET ® has been used in studies performed with critically ill patients [ 21 , 22 ], healthy volunteers [ 23 ] and surgical newborns [ 24 ]. Additionally, Ubbink [ 10 ] and Harms [ 25 ] et al have presented several case reports wherein mitochondrial oxygenation (mitoPO 2 ) measurements are described amid hemodynamically unstable surgical situations.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of mitochondrial oxygen tension in the operating theatre: An observational study with the novel COMET® monitor

et al. 2023

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Introduction The newly introduced Cellular Oxygen METabolism (COMET®) monitor enables the measurement of mitochondrial oxygen tension (mitoPO2) using the protoporphyrin IX triplet state lifetime technique (PpIX-TSLT). This study aims to investigate the feasibility and applicability of the COMET® measurements in the operating theatre and study the behavior of the new parameter mitoPO2 during stable operating conditions. Methods In this observational study mitochondrial oxygenation was measured in 20 patients during neurosurgical procedures using the COMET® device. Tissue oxygenation and local blood flow were measured by the Oxygen to See (O2C). Primary outcomes included mitoPO2, skin temperature, mean arterial blood pressure, local blood flow and tissue oxygenation. Results All patients remained hemodynamically stable during surgery. Mean baseline mitoPO2 was 60 ± 19 mmHg (mean ± SD) and mean mitoPO2 remained between 40–60 mmHg during surgery, but tended to decrease over time in line with increasing skin temperature. Conclusion This study presents the feasibility of mitochondrial oxygenation measurements as measured by the COMET® monitor in the operating theatre and shows the parameter mitoPO2 to behave in a stable and predictable way in the absence of notable hemodynamic alterations. The results provide a solid base for further research into the added value of mitochondrial oxygenation measurements in the perioperative trajectory.

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Mitochondrial Oxygen Monitoring During Surgical Repair of Congenital Diaphragmatic Hernia or Esophageal Atresia: A Feasibility Study

Cited by 6 publications

References 49 publications

Description of mitochondrial oxygen tension and its variability in healthy volunteers

Description of mitochondrial oxygen tension and its variability in healthy volunteers

Measuring Mitochondrial Oxygen Tension during Red Blood Cell Transfusion in Chronic Anemia Patients: A Pilot Study

Monitoring of mitochondrial oxygen tension in the operating theatre: An observational study with the novel COMET® monitor

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