Mark Wefers Bettink

Mitochondrial oxygen monitoring during surgical repair of congenital diaphragmatic hernia or esophageal atresia: 9 171 In the 12 successful measurements (Table 2) the mitoPO 2 interquartile range at start of the measurement was 51 – 60 mmHg. In all neonates the skin was examined on regular timepoints; after removing the ALA plaster after priming of the skin, directly after removing the COMET-sensor, at 24 hours and 48 hours after removing the COMET- sensor. No adverse events such as erythema or other signs of an irritated skin were observed. Table 2. Median and IQR values of the 12 successfully obtained measurements HR MABP Saturation rSO 2 MitoPO 2 Start measurement 133 (113 – 142) 41 (37 – 44) 96 (94 -97) 87 (66 – 93) 58 (51 – 60) +10 minutes 130 (112 – 146) 48 (40 – 53) 94 (91 – 97) 83 (69 – 92) 57 (55 – 64) +20 minutes 133 (118 – 140) 49 (40 – 62) 96 (93 – 97) 88 (69 – 93) 54 (53 – 63) +30 minutes 133 (122 – 151) 47 (44 – 49) 95 (94 – 97) 81 (74 – 93) 53 (49 – 60) +40 minutes 146 (135 – 160) 42 (35 – 46) 92 (90 – 97) 79 (70 – 88) 53 (52 – 56) +50 minutes 144 (137 – 156) 41 (35 – 48) 95 (91 – 99) 82 (72 – 89) 50 (48 – 54) +60 minutes 149 (137 – 164) 43 (39 – 45) 97 (91 – 99) 88 (77 – 95) 51 (49 – 54) +70 minutes 154 (136 – 166) 45 (40 – 48) 96 (92 – 97) 87 (65 – 94) 52 (49 – 58) +80 minutes 150 (137 – 168) 45 (35 – 46) 96 (95 – 99) 86 (71 – 95) 52 (47 – 59) +90 minutes 151 (133 – 168) 42 (37 – 48) 97 (91 – 99) 83 (67 – 94) 53 (52 – 59) +100 minutes 157 (124 – 163) 42 (39 – 45) 96 (92 – 99) 78 (65 – 91) 51 (50 – 63) +110 minutes 133 (121 – 168) 46 (42 – 52) 97 (93 – 99) 84 (68 – 91) 53 (50 – 64) +120 minutes 137 (127 – 171) 42 (37 – 52) 96 (92 – 99) 77 (74 – 91) 48 (45 – 53) Two cases illustrate fluctuations in mitoPO 2 in relation to surgical and anesthetic actions. Case 1 (figure 2A) is a female neonate, gestational age 37 weeks, birth weight 2,500 grams, with CDH requiring veno-arterial ECMO treatment due to therapy-resistant pulmonary hypertension. Surgical treatment was on day 8 of life, during ECMO. Priming of the skin with ALA was 6 hours. During surgery bleeding intercostal arteries caused significant blood loss. Vital parameters and rSO 2 remained unchanged, but mitoPO 2 decreased from 62mmHg at start surgery to 36mmHg (a reduction of 42%) during blood loss and partially recovered after supplementation with erythrocyte transfusion with a mitoPO 2 up to 53mmHg at the end of the surgery.