A monitor for Cellular Oxygen METabolism (COMET): monitoring tissue oxygenation at the mitochondrial level

A monitor for Cellular Oxygen METabolism (COMET): monitoring tissue oxygenation at the mitochondrial level

After introduction of the protoporphyrin IX-triplet state lifetime technique as a new method to measure mitochondrial oxygen tension in vivo, the development of a clinical monitor was started. This monitor is the “COMET”, an acronym for Cellular Oxygen METabolism. The COMET is a non-invasive electri...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing Vol. 31; no. 6; pp. 1143 - 1150
Main Authors: Ubbink, Rinse, Bettink, Mark A. Wefers, Janse, Rineke, Harms, Floor A., Johannes, Tanja, Münker, F. Michael, Mik, Egbert G.
Format: Journal Article
Language:English
Published: Dordrecht Springer Netherlands 01-12-2017
Springer Nature B.V
Subjects:
Aminolevulinic Acid - chemistry
Anesthesiology
Biocompatibility
Biocompatible Materials - chemistry
Critical Care Medicine
Equipment Design
Health Sciences
Humans
Hypertension
In vivo methods and tests
Intensive
Lasers
Medicine
Medicine & Public Health
Metabolism
Microcirculation
Mitochondria
Mitochondria - metabolism
Monitoring, Ambulatory - methods
Original Research
Oxygen - metabolism
Oxygen Consumption
Oxygen content
Oxygen tension
Oxygenation
Protoporphyrins - chemistry
Signal Processing, Computer-Assisted
Skin
Skin - metabolism
Skin - pathology
Statistics for Life Sciences
Touch screens
Vasoconstriction
Mitochondrial oxygen tension (mitoPO
)
Diagnostics
PpIX-TSLT
COMET
Tissue oxygenation
Mitochondrial oxygen tension (mitoPO2)
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Summary:After introduction of the protoporphyrin IX-triplet state lifetime technique as a new method to measure mitochondrial oxygen tension in vivo, the development of a clinical monitor was started. This monitor is the “COMET”, an acronym for Cellular Oxygen METabolism. The COMET is a non-invasive electrically powered optical device that allows measurements on the skin. The COMET is easy to transport, due to its lightweight and compact size. After 5-aminolevulinic acid application on the human skin, a biocompatible sensor enables detection of PpIX in the mitochondria. PpIX acts as a mitochondrially located oxygen-sensitive dye. Three measurement types are available in the touchscreen-integrated user interface, ‘Single’, ‘Interval’ and ‘Dynamic measurement’. COMET is currently used in several clinical studies in our institution. In this first description of the COMET device we show an incidental finding during neurosurgery. To treat persisting intraoperative hypertension a patient was administered clonidine, but due to rapid administration an initial phase of peripheral vasoconstriction occurred. Microvascular flow and velocity parameters measured with laser-doppler (O2C, LEA Medizintechnik) decreased by 44 and 16% respectively, but not the venous-capillary oxygen saturation. However, mitochondrial oxygen tension in the skin detected by COMET decreased from a steady state of 48 to 16 mmHg along with the decrease in flow and velocity. We conclude that COMET is ready for clinical application and we see the future for this bedside monitor on the intensive care, operating theater, and testing of mitochondrial effect of pharmaceuticals.
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ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-016-9966-x