Windpassinger Marita, Prusak Michal, Ruetzler Kurt, Plattner Olga, Stanisz Isabella, Haider Patrick
Department of Anesthesia, Critical Care and Pain Medicine, Division of General Anesthesia and Intensive Care Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Outcome Research Consortium, Houston, TX 77030, USA.
J Clin Med. 2025 Sep 17;14(18):6528. doi: 10.3390/jcm14186528.
: Mitochondrial DNA (mtDNA), normally enclosed within mitochondria, can be released into circulation in response to cellular stress, hypoxia, or inflammation. Its detection in plasma has been proposed as a marker of cellular injury, particularly in the context of mechanical ventilation. High-frequency jet ventilation is a specialized approach of open-airway ventilation, delivering small tidal volumes through jet gas streams, applied with high pressure and oxygen fraction. It remains unclear whether this mode of ventilation contributes to mitochondrial stress. We therefore hypothesized that circulating mtDNA levels would increase after jet ventilation due to the combined effects of high oxygen exposure and mechanical strain. Furthermore, we explored whether the magnitude of mtDNA change correlates with the duration of ventilation and arterial oxygenation levels. : Plasma levels of cell-free circulating mitochondrial DNA were measured in 30 patients before and following jet ventilation in laryngotracheal surgery. Post hoc analysis of a primary monocentric, randomized cross-over study was conducted to investigate ventilation distribution in high-frequency jet ventilation techniques. Mitochondrial DNA levels significantly decreased after jet ventilation (median T0: 13.57; T1: 6.78; = 0.0087). No significant associations were found between mtDNA change and jet ventilation duration, type of surgery, or ASA classification. Despite variable air entrainment in the open-jet ventilation system, the arterial partial pressure of oxygen increased significantly during the procedure. : Jet ventilation was associated with a significant decrease in circulating mtDNA levels. This contrasts with our initial hypothesis of mtDNA elevation under ventilation-induced stress. These findings suggest that jet ventilation may exert less mitochondrial damage than previously expected.
线粒体DNA（mtDNA）通常包裹在线粒体内，可因细胞应激、缺氧或炎症反应而释放到循环系统中。血浆中mtDNA的检测已被提议作为细胞损伤的标志物，尤其是在机械通气的情况下。高频喷射通气是一种特殊的气道开放通气方法，通过喷射气流输送小潮气量，施加高压和氧浓度。目前尚不清楚这种通气模式是否会导致线粒体应激。因此，我们假设喷射通气后循环mtDNA水平会因高氧暴露和机械应变的综合作用而升高。此外，我们还探讨了mtDNA变化的幅度是否与通气持续时间和动脉氧合水平相关。在30例喉气管手术患者中，在喷射通气前后测量了血浆中游离循环线粒体DNA的水平。对一项单中心、随机交叉研究进行事后分析，以研究高频喷射通气技术中的通气分布情况。喷射通气后线粒体DNA水平显著降低（中位数T0：13.57；T1：6.78；P = 0.0087）。未发现mtDNA变化与喷射通气持续时间、手术类型或ASA分级之间存在显著关联。尽管开放式喷射通气系统中的空气夹带情况各不相同，但术中动脉血氧分压显著升高。喷射通气与循环mtDNA水平的显著降低相关。这与我们最初关于通气诱导应激下mtDNA升高的假设相反。这些发现表明，喷射通气可能比之前预期的对线粒体造成的损伤更小。
