Mitochondrial oxygen monitoring with COMET: verification of calibration in man and comparison with vascular occlusion te
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ORIGINAL RESEARCH
Mitochondrial oxygen monitoring with COMET: verification of calibration in man and comparison with vascular occlusion tests in healthy volunteers R. Ubbink1 · M. A. Wefers Bettink1 · W. van Weteringen2 · E. G. Mik1 Received: 1 April 2020 / Accepted: 1 October 2020 © The Author(s) 2020
Abstract Mitochondria are the primary consumers of oxygen and therefore an important location for oxygen availability and consumption measurement. A technique has been developed for mitochondrial oxygen tension ( mitoPO2) measurement, incorporated in the COMET. In contrast to most textbooks, relatively high average mitoPO2 values have been reported. The first aim of this study was to verify the validity of the COMET calibration for mitoPO2 measurements in human skin. The second aim was to compare the dynamics of m itoPO2 to several other techniques assessing tissue oxygenation. Firstly, we performed a two-point calibration. Mitochondrial oxygen depletion was achieved with vascular occlusion. A high m itoPO2 was reached by local application of cyanide. M itoPO2 was compared to the arterial oxygen partial pressure ( PaO2). Secondly, for deoxygenation kinetics we compared COMET variables with the LEA O2C, SenTec OxiVenT™ and Medtronic INVOS™ parameters during a vascular occlusion test. 20 healthy volunteers were recruited and resulted in 18 datasets (2 times 9 subjects). The lowest measured m itoPO2 value per subject had a median [IQR] of 3.0 [1.0–4.0] mmHg, n = 9. After cyanide application the mitoPO2 was 94.1 mmHg [87.2–110.9] and did not differ significantly (n = 9, p = 0.5) from the PaO2 of 101.0 [98.0–106.0] mmHg. In contrast to O2C, OxiVenT™ and INVOS parameters, mitoPO2 declined within seconds with pressure on the probe. The kinetics from this decline are used to mitochondrial oxygen consumption ( mitoVO2). This study validates the calibration of the COMET device in humans. For mitoVO2 measurements not only blood flow cessation but application of local pressure is of great importance to clear the measurement site of oxygen-carrying erythrocytes. Keywords COMET · Diagnostics · Mitochondrial oxygen tension (mitoPO2) · PpIX-TSLT · 5-aminolevulinic acid
1 Introduction Mitochondria are small intracellular organelles that generate energy for the cells in the form of adenosine triphosphate (ATP). Oxygen is of critical importance for efficient ATP generation through the process of oxidative phosphorylation, also called mitochondrial respiration. This function makes mitochondria the primary consumers of oxygen in the body
* R. Ubbink [email protected] 1
Department of Anesthesiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Department of Pediatric Surgery, Erasmus MC—Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
2
and therefore the most desired location for measuring oxygen availability and consumption. An optical noninvasive technique has been developed for measuring mitochondrial oxygen tension (mit
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