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

Introduction The newly introduced Cellular Oxygen METabolism (COMET (R)) monitor enables the measurement of mitochondrial oxygen tension (mitoPO(2)) using the protoporphyrin IX triplet state lifetime technique (PpIX-TSLT). This study aims to investigate the feasibility and applicability of the COMET (R) 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 (R) device. Tissue oxygenation and local blood flow were measured by the Oxygen to See (O2C). Primary outcomes included mitoPO(2), skin temperature, mean arterial blood pressure, local blood flow and tissue oxygenation. Results All patients remained hemodynamically stable during surgery. Mean baseline mitoPO(2) was 60 +/- 19 mmHg (mean +/- SD) and mean mitoPO(2) 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 (R) monitor in the operating theatre and shows the parameter mitoPO(2) 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.