COMET: monitoring mitochondrial shock in anesthesiology and intensive care medicine

Mitochondria, as the cellular end-users of oxygen and responsible for approximately 98% of total body oxygen consumption, play a significant role in the development of organ dysfunction during shock. Therefore, integrating information on mitochondrial oxygen homeostasis with macroscopic observations...

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Published inANESTHESIOLOGY AND PERIOPERATIVE SCIENCE Vol. 2; no. 4; pp. 1 - 11
Main Authors Yang, Yan, Zhang, Wei, Ma, Zhengliang, Gu, Xiaoping
Format Journal Article
LanguageEnglish
Published Singapore Springer Nature Singapore 13.11.2024
Springer
Subjects
Anesthesiology
COMET
Critical Care Medicine
Intensive
Medicine
Medicine & Public Health
Mitochondrial oxygen metabolism
Neurosciences
Non-invasive monitoring at the bedside
Pharmacology/Toxicology
PpIX-TSLT
Review Article
Surgery
Mitochondrial oxygen metabolism
PpIX-TSLT
COMET
Non-invasive monitoring at the bedside
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Summary:Mitochondria, as the cellular end-users of oxygen and responsible for approximately 98% of total body oxygen consumption, play a significant role in the development of organ dysfunction during shock. Therefore, integrating information on mitochondrial oxygen homeostasis with macroscopic observations of macrocirculation and microcirculation is crucial for monitoring critically ill patients or those undergoing high-risk surgery. However, current clinical practice still lack reliable surrogate parameters for assessing mitochondrial function. The Cellular Oxygen METabolism (COMET) monitor, utilizing the protoporphyrin IX triplet state lifetime technique (PpIX-TSLT), represents the first clinical device capable of non-invasive, in vivo measurement of mitochondrial oxygen pressure and oxidative phosphorylation. Recent research suggests that implementing this real-time bedside monitoring will provide additional insights into microcirculatory dynamics and enhance patient management. This review will comprehensively detail the rationale, methodologies, evolution, and clinical applications of the technique, aiming at improving the understanding of mitochondrial pathology in daily clinical practice and facilitating the development of targeted therapeutic strategies. Graphical Abstract
ISSN:2731-8389
2731-8389
DOI:10.1007/s44254-024-00079-x