Mark Wefers Bettink

Chapter 10 186 during neurosurgery. The advantage of measuring in neurosurgery is the overall stability of the patients undergoing these operations and the duration of the procedure needed to perform neurosurgery. We were able to obtain stable measurements of mitochondrial oxygenation during stable operating conditions. It was possible to monitor mitochondrial oxygenation in neonates during congenital esophageal atresia or diaphragmatic hernias repair operations, as described in chapter 9 . Overall the technique did not cause any damage to the skin of the neonates and in 12 out of 15 cases intra operative monitoring was possible. In 3 of these 15 patients measurement of mitochondrial oxygenation was not possible, external and potentially preventable factorswere at least partly responsible for failureof themonitoring technique. Exposition of the measurement site to infra-red light, a potent light source, caused depletion of the buildup PpIX. Purple skin marker or the disinfectant chlorohexidine causes excess delayed fluorescence and thereby failure to measure the mitochondrial source. Preliminary data showed the sensitivity of mitoPO 2 to the perturbations in physiological status caused by the operation or anesthesia. We showed it is possible to measure mitoPO 2 in neonates and its possible additional value next to the standard monitoring modalities used.