Perioperative medicine & outcomes
Personalized intraoperative arterial pressure management and mitochondrial oxygen tension in patients having major non-cardiac surgery: a pilot substudy of the IMPROVE trial
Authors' conclusion
MitoPO2 under general anesthesia was about a quarter lower than preoperative awake mitoPO2, substantially fluctuated during major non-cardiac surgery, and transiently decreased below 20 mmHg in about two-thirds of the patients. Personalized - compared to routine - intraoperative arterial pressure management did not increase intraoperative mitoPO2.
Study context
- Population
- Patients having major non-cardiac surgery under GA
- Participants
- 19 patients
- Comparison
- Personalized vs routine intraoperative arterial pressure management
- Personalizedn = 10
- Routinen = 9reference
- Primary endpoint
- Mitochondrial oxygen tension (mitoPO2) in the skin (Cellular Oxygen METabolism (COMET) system), from induction of GA until end of surgery
Methodological detailspre-planned pilot substudy
- Pre-planned pilot substudy
Primary result
As reported in the abstract
mitoPO2, overall cohort
- Preoperative awake mitoPO2, median (25th to 75th percentile), mmHg
- 63 (53 to 82)
- mitoPO2 after induction of GA, median (25th to 75th percentile), mmHg
- 42 (35 to 59)
- Intraoperative average mitoPO2, median (25th to 75th percentile), mmHg
- 39 (30 to 50)
- Patients with intraoperative mitoPO2 <20 mmHg
- 13 (68%)
- Median % of surgical time with mitoPO2 <20 mmHg (25th to 75th percentile)
- 17 (0 to 31)%
Further findings
| Outcome | Rrm(984) (95% CI) | P value |
|---|---|---|
| Correlation of mitoPO2 with MAP (repeated measures correlation)mitoPO2 vs MAP · weak correlation | 0.26 (0.20–0.32) | P < 0.001 |
| Correlation of mitoPO2 with heart rate (repeated measures correlation)mitoPO2 vs heart rate · not meaningfully correlated | −0.05 (−0.11 to 0.01) | P = 0.117 |
| Intraoperative average mitoPO2, Personalized vs RoutineNo important difference | P = 0.653 |
Original publication
Personalized intraoperative arterial pressure management and mitochondrial oxygen tension in patients having major non-cardiac surgery: a pilot substudy of the IMPROVE trial. J Clin Monit Comput. Published 7 February 2025. doi:10.
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