Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany; Septomics Research Center, Jena University Hospital, Jena, Germany.
Institute of Physiotherapy, Jena University Hospital, Jena, Germany.
Biochim Biophys Acta Mol Basis Dis. 2019 Apr 1;1865(4):749-758. doi: 10.1016/j.bbadis.2018.12.003. Epub 2018 Dec 26.
Impaired tissue oxygenation is the key pathomechanism in the development of organ dysfunction in shock; mitochondrial impairment can aggravate the condition. However, measuring tissue oxygenation directly and non-invasively still poses a clinical challenge. A novel device (COMET) allows the assessment of mitochondrial oxygen metabolism using the Protoporphyrin IX Triplet State Lifetime Technique (PpIX-TSLT). Critically ill patients, especially in sepsis, often exhibit oedema which may interfere with the COMET measurement. Furthermore, patients' physical activity level differs significantly before and during hospitalisation. Thus, the aim of this study was to identify the effects of physical activity and body composition on mitochondrial oxygen tension (mitoPO) and consumption (mitoVO) in healthy controls (N = 40). Furthermore, the study tested the repeatability of the COMET variables and identified covariates. Multiple COMET measurements were performed before (T, T), during and after (T, T) ergometry. Body composition was assessed by bioimpedance analysis. Physiological variables (blood pressure, heart rate, oxygen saturation) were recorded. In the analytical sample (n = 26), physical activity significantly decreased mitoVO; other COMET variables remained unchanged between T and T. During ergometry, mitoPO increased significantly. The distribution of body water significantly influenced mitoVO. In our setting, the method demonstrated moderate repeatability. Variables of fitness (heart rate recovery, phase angle and physical activity level), signal quality and duration of exposure to 5-aminolevulinic acid (obligatory for PpIX-TSLT) were identified as significant covariates of mitoVO. Mitochondrial oxygen delivery (mitoDO) was established as a new variable of COMET analysis. Results of this pilot study should be validated in future studies.
组织氧合受损是休克导致器官功能障碍的关键发病机制;线粒体功能障碍会加重这种情况。然而,直接和非侵入性地测量组织氧合仍然是一个临床挑战。一种新的设备(COMET)允许使用原卟啉 IX 三重态寿命技术(PpIX-TSLT)评估线粒体氧代谢。危重症患者,特别是脓毒症患者,常表现出水肿,这可能会干扰 COMET 的测量。此外,患者在住院前后的身体活动水平有很大差异。因此,本研究的目的是确定身体活动和身体成分对健康对照组(N=40)中线粒体氧张力(mitoPO)和消耗(mitoVO)的影响。此外,该研究还测试了 COMET 变量的可重复性并确定了协变量。在运动前(T1、T2)、运动中和运动后(T3、T4)进行多次 COMET 测量。通过生物阻抗分析评估身体成分。记录生理变量(血压、心率、血氧饱和度)。在分析样本(n=26)中,身体活动显著降低了 mitoVO;T1 和 T2 之间其他 COMET 变量保持不变。在运动过程中,mitoPO 显著增加。身体水分的分布显著影响 mitoVO。在我们的设定中,该方法表现出中等的可重复性。适应性变量(心率恢复、相位角和身体活动水平)、信号质量和暴露于 5-氨基酮戊酸的时间(PpIX-TSLT 的必需条件)被确定为 mitoVO 的显著协变量。线粒体氧输送(mitoDO)被确立为 COMET 分析的一个新变量。本研究的结果应在未来的研究中进行验证。