Journal of Clinical Monitoring and Computing最新文献

{"title":"Improving urinary oxygen monitoring with a transit time algorithm: enhancing AKI detection in cardiac surgery.","authors":"Ali Ramezani, Natalie Silverton, Kai Kuck","doi":"10.1007/s10877-025-01298-8","DOIUrl":"https://doi.org/10.1007/s10877-025-01298-8","url":null,"abstract":"<p><p>Acute kidney injury (AKI) affects 40-50% of cardiac surgery patients and is closely linked to renal medullary hypoxia. Although urinary oxygen partial pressure (PuO₂) offers real-time insight into renal oxygenation, variable urine transit times through the urinary catheter can impair measurement accuracy. This study aimed to develop an algorithm that calculates transit time by modeling urine flow as discrete particles and to assess whether it improves PuO₂ estimation. The proposed algorithm models urine flow as discrete particles, tracking transit time through the urinary catheter. The transit time allows correcting oxygen measurements at the catheter exit, mitigating distortions from variable flow rates. Validation used a bench-top system with a flow sensor, a 30-cm glass tube simulating a catheter, and optode-based oxygen sensors positioned inside a flask and at the catheter entry and exit. Flow rates spanned 20-450 mL/h, and flask oxygen 15-120 mmHg, with exit compared to entrance values. Without adjustment, the root mean square error (RMSE) between entrance and exit oxygen measurements was 15.71 mmHg. Incorporating the transit time correction reduced the RMSE to 5.82 mmHg. This marked improvement indicates that the corrected measurements more accurately reflect the true oxygen levels entering the catheter across various flow conditions. By accounting for dynamic urine transit times, the proposed algorithm substantially enhances the accuracy of urinary oxygen monitoring. This improvement in estimating renal oxygenation may facilitate noninvasive detection of renal hypoxia and allow for timely interventions to reduce the incidence and severity of AKI in cardiac surgery patients.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart rate variability as a marker of multiple organ dysfunction syndromes: a systematic review.","authors":"Anne Wojtanowski, Maxence Hureau, Mathieu Jeanne, Côme Bureau, Morgan Recher, Julien De Jonckheere","doi":"10.1007/s10877-025-01296-w","DOIUrl":"https://doi.org/10.1007/s10877-025-01296-w","url":null,"abstract":"<p><p>Multiple organ dysfunction syndrome (MODS) can be caused by many factors. Assessments of the severity of MODS are currently based on occasional measurements of several clinical variables (laboratory data, vital signs, etc.). The analysis of heart rate variability (HRV) as a guide to autonomic nervous system activity might be of value in the continuous assessment of the severity of MODS. We systematically reviewed publications on the value of HRV variables for the diagnosis of MODS in patients of any age admitted to the ICU. Two investigators independently searched the PubMed, Embase, Cochrane and Science Direct databases for articles in English or French published between 2004 and 2024. Ten studies were included and rated for endpoint bias (MODS or mortality), using the revised Quality Assessment of Diagnostic Accuracy Studies. Nine studies assessed MODS, and six assessed mortality. All the studies evidenced low HRV in patients with MODS and in non-survivors. The results of our review show that HRV indices are influenced by the severity of MODS and might serve as a tool for predicting mortality in patients with MODS. However, patient characteristics, and treatments and HRV processing methods must be taken into account when interpreting the results. In order to clarify the impact of MODS on HRV variables, methodologically rigorous studies are now needed.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG features associated with Alzheimer's disease and Frontotemporal dementia are not reflected by processed indices used in anesthesia monitoring.","authors":"Stefan Schwerin, Srdjan Z Dragovic, Julian Ostertag, Duy-Minh Nguyen, Gerhard Schneider, Matthias Kreuzer","doi":"10.1007/s10877-025-01294-y","DOIUrl":"https://doi.org/10.1007/s10877-025-01294-y","url":null,"abstract":"<p><p>Patients with dementia face increased risks after general anesthesia. Improved perioperative electroencephalogram (EEG) monitoring techniques could aid in identifying vulnerable patients. However, current technology relies on processed indices to measure \"depth-of-anesthesia\". Analyzing OpenNeuro Dataset ds004504, we compared resting-state, eyes-closed EEG recordings of healthy controls (n = 27) with patients diagnosed with Alzheimer's disease (AD, n = 35) and Frontotemporal dementia (FTD, n = 23). We focused on prefrontal recordings. Analysis included spectral analysis, the \"fitting-oscillations&-one-over-f\"-algorithm for aperiodic and periodic signal features, as well as calculations of openibis, permutation entropy (PeEn), spectral entropy (SpEn), and spectral edge frequency (SEF). Spectral differences were pronounced, including a higher alpha/theta-ratio of controls (2.62 [95%CI: 1.54-3.62]) compared to both AD (0.55 [95%CI: 0.26-1.92], P < 0.001, AUC: 0.765 [0.642-0.888]) and FTD (0.83 [95%CI: 0.33-1.65], P = 0.007, AUC: 0.779 [0.652-0.907]). Oscillatory peak detection within the alpha frequency band was more robust in control (versus AD: P = 0.003, Cramér's V = 0.374; versus FTD: P = 0.003, Cramér's V = 0.414). Processed index parameters did not show a clear trend. FTD was associated with a higher prefrontal openibis (95.53 [95%CI: 93.43-97.39]) than control (91.98 [95%CI: 89.46-96.27], P = 0.033, AUC: 0.717 [0.572-0.862]) and an elevated SEF (23.68 [95%CI: 14.10-25.57] Hz) compared to AD (16.60 [95%CI: 14.22-22.22] Hz, P = 0.041, AUC: 0.676 [0.532-0.821]). AD and FTD are associated with EEG baseline abnormalities, and a standard prefrontal montage, as used intraoperatively, could present a promising technical screening approach for cognitive vulnerability. However, these EEG features are obscured by processed index parameters currently used in neuroanesthesia monitoring. OpenNeuro Dataset ds004504 \"A dataset of EEG recordings from: Alzheimer's disease, Frontotemporal dementia and Healthy subjects\" (doi: https://doi.org/10.18112/openneuro.ds004504.v1.0.7 ).</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A smartphone application for semi-automated QT interval analysis based on a snapshot of an electrocardiogram trace displayed on a patient monitor.","authors":"David Beckmann, Moritz Flick, Karim Kouz, Bernd Saugel","doi":"10.1007/s10877-025-01277-z","DOIUrl":"https://doi.org/10.1007/s10877-025-01277-z","url":null,"abstract":"<p><p>We developed a smartphone application (SMART-QT application) that can semi-automatically measure QT and QTc intervals based on a snapshot of the electrocardiogram (ECG) trace and the heart rate displayed on a patient monitor. In this study, we aimed to validate the SMART-QT application. In this prospective single-center method comparison study, we measured QT and QTc intervals with the SMART-QT application (QT_APP and QTc_APP; test method) and simultaneously manually measured QT and QTc intervals from a 12-lead ECG (QT_REF and QTc_REF; reference method) in 57 adult volunteers and patients who had sinus rhythm and no acute or chronic cardiac comorbidities. To investigate the agreement between QT_APP and QT_REF and between QTc_APP and QTc_REF, we performed Bland-Altman analyses and calculated the mean of the differences, the standard deviation, and the 95%-limits of agreement (95%-LOA). We defined clinically acceptable agreement as maximum mean of the differences ± standard deviation of 20 ± 20 ms. The mean of the differences between QT_APP and QT_REF was 14 ± 20 ms (95%-LOA -26 to 54 ms). The mean of the differences between QTc_APP and QTc_REF was 13 ± 15 ms (95%-LOA -16 to 42 ms). The agreement between QT_APP and QT_REF and between QTc_APP and QTc_REF was clinically acceptable in adult volunteers and patients without cardiac comorbidities.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is quantitative pupillometry affected by ambient light? A prospective crossover study.","authors":"Sanna Holmskär, Malin Öhrn, Moa Furudahl, Johannes Kesti, Jakob Pansell","doi":"10.1007/s10877-025-01293-z","DOIUrl":"https://doi.org/10.1007/s10877-025-01293-z","url":null,"abstract":"<p><strong>Purpose: </strong>Pupillary examination is a central part of the neurological assessment. While quantitative pupillometry (QP) improves reliability, the impact of ambient light, particularly on the Neurological Pupil index (NPi), remains unclear. This study aimed to clarify the effects of ambient light on QP parameters in a critical care setting.</p><p><strong>Methods: </strong>We performed a prospective crossover study, including 20 adult patients requiring invasive ventilation. Pupillometry was performed during bright condition (BC1), then dark condition (DC), then bright condition again (BC2). In our primary analysis we compared NPi values across conditions (DC1 vs. BC, BC vs. DC2, DC1 vs. DC2). In the secondary analysis, we compared all other QP parameters.</p><p><strong>Results: </strong>All QP values except constriction velocity and dilation velocity were non-normal. The median NPi was significantly lower in BC compared to dark conditions DC1 in both eyes. In 25% of participants the NPi decreased by 0.6 or more. Conversely, a significant increase in median NPi of both eyes was observed when switching from bright conditions back to dark (BC vs. DC2). No significant difference was found between the two dark condition measurements (DC1 and DC2). The secondary analysis showed that the differences in NPi were driven by differences in most, but not all, QP parameters included in NPi.</p><p><strong>Conclusions: </strong>We corroborate previous findings that the level of ambient light affects QP parameters in critically ill patients. This needs to be considered for accurate interpretation of QP parameters. Future studies may explore potential automated light correction methods for wider clinical applicability.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of fluid responsiveness by changes of perfusion index and pleth-variability index during passive leg raising in spontaneously breathing post-surgical patients: a prospective interventional study.","authors":"Simon Rauch, Paolo Mario Seraglio, Tomas Dal Cappello, Giulia Roveri, Markus Falk, Matthias Bock","doi":"10.1007/s10877-025-01292-0","DOIUrl":"https://doi.org/10.1007/s10877-025-01292-0","url":null,"abstract":"<p><p>Predicting fluid responsiveness is crucial in treating circulatory failure, as only about half of patients benefit from volume expansion by increasing cardiac output (CO). Dynamic tests like passive leg raising (PLR) are preferred over static parameters. While PLR reliably predicts fluid responsiveness, it typically requires invasive measurement of stroke volume (SV) or CO. The perfusion index (PI) and pleth variability index (PVI) are non-invasive metrics derived from oxygen saturation signals. PI has been shown to correlate with SV, and PVI has predicted fluid responsiveness in mechanically ventilated patients, but their role in spontaneously breathing patients remains unclear. This study aimed to assess whether PI and PVI could predict fluid responsiveness in post-surgical, spontaneously breathing patients during a PLR test. The hypothesis was that PI would increase and PVI would decrease in fluid responders. The prospective study included spontaneously breathing patients after major abdominal surgery in the ICU of Merano Hospital, Italy. SV and CO were measured using the FloTrac™ system, and PI and PVI were assessed using the Radical 7^® monitor. Patients were considered responders if SV increased by ≥ 10% during the PLR test. Of the 47 patients enrolled, 23 (48.9%) were fluid responders. The percentage change in PI from baseline to 60 s into the PLR test was + 41.2% in responders and + 11.3% in non-responders. A PI increase of ≥ 23% predicted responders with 70% sensitivity and 75% specificity, with an area under the ROC curve of 0.74. Twenty-two patients (47%) were inside the grey zone. PVI did not differ significantly between groups. In conclusion, PI could be a helpful non-invasive tool for predicting fluid responsiveness during a PLR test in spontaneously breathing patients, though its diagnostic accuracy appears to be moderate.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small changes in the transducer position cause a systematic change in cardiac output readings: implications for clinical practice.","authors":"Caroline Dinesen, Simon Tilma Vistisen, Peter Juhl-Olsen","doi":"10.1007/s10877-024-01230-6","DOIUrl":"10.1007/s10877-024-01230-6","url":null,"abstract":"<p><p>To systematically evaluate the effect of small changes in transducer position on key hemodynamic variables including CO generated by 4th generation FloTrac software. After cardiac surgery, cardiac output, mean arterial pressure, systemic vascular resistance, and stroke volume variation were measured with 4 generation Flotrac software. The transducer position was randomly placed at the midaxillary plane, 4 cm higher than the midaxillary plane or 4 cm lower than the midaxillary plane. Averages of three measurements were used. Data was available from 20 patients. Cardiac output increased from 4.59 L/min (± 0.92) to 4.78 L/min (± 0.99) with the transducer position at the midaxillary plane to 4 cm higher than the midaxillary plane, and cardiac output decreased to 4.43 L/min (± 0.90) with the transducer 4 cm lower than midaxillary plane (P < 0.001). On the relative scale, CO increased 4.1% (95% CI 3.1-5.0) when comparing the higher transducer level with the midaxillary plane position, and CO decreased 3.4% (95% CI 2.4-4.4) when comparing the midaxillary plane position with the lower transducer level, correspondiong to changes in CO of ≈ 1% per 1 cm change in transducer position. Mean arterial pressure and systemic vascular resistance both changed significantly with transducer position (both P < 0.001), whereas no statistically or clinically significant effect was seen on stroke volume variation (P = 0.98). A four-centimeter change in vertical transducer position induced clinically significant changes in cardiac output measurements by 4th generation FloTrac software. Definitions of optimal cardiac output in goal-directed therapy algorithms require meticulous transducer adjustment and can only be used in the reference patient position.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"365-369"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of early perioperative stroke after cardiothoracic surgery with intraoperative regional cerebral oxygenation using near-infrared spectroscopy: an observational cohort study comparing affected versus non-affected hemispheres.","authors":"Ramon Pierik, Thomas W L Scheeren, Michiel E Erasmus, Walter M van den Bergh","doi":"10.1007/s10877-024-01241-3","DOIUrl":"10.1007/s10877-024-01241-3","url":null,"abstract":"<p><strong>Purpose: </strong>Patients undergoing cardiothoracic surgery are at risk of developing perioperative stroke, but residual effects of anesthesia may hamper timely detection. This study aims to determine if there is an association between intraoperative regional cerebral oxygenation (ScO₂) monitoring using near-infrared spectroscopy (NIRS) and the occurrence of early perioperative stroke within three days after cardiothoracic surgery.</p><p><strong>Methods: </strong>We performed a single-center retrospective observational cohort study including all consecutive cardiothoracic surgery patients with routinely perioperative ScO₂ monitoring admitted postoperatively to the Intensive Care Unit (ICU) between 2008 and 2017. Patients with a confirmed stroke in the anterior cerebral circulation on brain imaging were included in the analysis. Intraoperative area under the curve (AUC), duration, and total ScO₂ excursions below predefined thresholds (< 50% ScO₂ or > 20% reduction below baseline) were calculated for each hemisphere. Stroke-affected and non-affected hemispheres were compared using logistic regression analyses to investigate a potential association between ScO₂ values and stroke.</p><p><strong>Results: </strong>Of the 2454 cardiothoracic surgery patients with perioperative ScO₂ monitoring, 39 had a anterior stroke on brain imaging. ScO₂ readings of 44 affected hemispheres were compared to 34 non-affected hemispheres. Only the duration of ScO₂ < 50% or a > 20% drop from baseline were significantly associated with global ischemia (OR 1.30 (0.95%CI; 1.09-2.30)) when comparing affected (72 [5 to 33] min.) versus non-affected (28 [4 to 44] min.) hemispheres.</p><p><strong>Conclusion: </strong>The duration of ScO₂ values < 50% or a drop > 20% from baseline were associated with the occurrence of early perioperative global cerebral ischemia within three days after cardiothoracic surgery.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"271-281"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive estimation of PaCO₂ from volumetric capnography in animals with injured lungs: an Artificial Intelligence approach.","authors":"Gerardo Tusman, Adriana G Scandurra, Stephan H Böhm, Noelia I Echeverría, Gustavo Meschino, P Kremeier, Fernando Suarez Sipmann","doi":"10.1007/s10877-024-01253-z","DOIUrl":"10.1007/s10877-024-01253-z","url":null,"abstract":"<p><p>To investigate the feasibility of non-invasively estimating the arterial partial pressure of carbon dioxide (PaCO₂) using a computational Adaptive Neuro-Fuzzy Inference System (ANFIS) model fed by noninvasive volumetric capnography (VCap) parameters. In 14 lung-lavaged pigs, we continuously measured PaCO₂ with an optical intravascular catheter and VCap on a breath-by-breath basis. Animals were mechanically ventilated with fixed settings and subjected to 0 to 22 cmH₂O of positive end-expiratory pressure steps. The resultant 8599 pairs of data points - one PaCO₂ value matched with twelve Vcap and ventilatory parameters derived in one breath - fed the ANFIS model. The data was separated into 7370 data points for training the model (85%) and 1229 for testing (15%). The ANFIS analysis was repeated 10 independent times, randomly mixing the total data points. Bland-Altman plot (accuracy and precision), root mean square error (quality of prediction) and four-quadrant and polar plots concordance indexes (trending ability) between reference and estimated PaCO₂ were analyzed. The Bland-Altman plot performed in 10 independent tested ANFIS models showed a mean bias between reference and estimated PaCO₂ of 0.03 ± 0.03 mmHg, with limits of agreement of 2.25 ± 0.42 mmHg, and a root mean square error of 1.15 ± 0.06 mmHg. A good trending ability was confirmed by four quadrant and polar plots concordance indexes of 95.5% and 94.3%, respectively. In an animal lung injury model, the Adaptive Neuro-Fuzzy Inference System model fed by noninvasive volumetric capnography parameters can estimate PaCO₂ with high accuracy, acceptable precision, and good trending ability.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"415-425"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid non-invasive measurement of mitochondrial oxygen tension after microneedle pre-treatment: a feasibility study in human volunteers.","authors":"B N Hilderink, N P Juffermans, J Pillay","doi":"10.1007/s10877-024-01249-9","DOIUrl":"10.1007/s10877-024-01249-9","url":null,"abstract":"<p><p>Mitochondrial oxygen tension (MitoPO2) is a promising novel non-invasive bedside marker of circulatory shock and is associated with organ failure. The measurement of mitoPO2 requires the topical application of 5-aminolevulinc acid (ALA) to induce sufficient concentrations of the fluorescent protein protoporphyrin-IX within (epi)dermal cells. Currently, its clinical potential in guiding resuscitation therapies is limited by the long induction time prior to obtaining a reliable measurement signal. We investigated whether microneedle pre-treatment of the skin before ALA application allows for earlier measurement of mitoPO2 in healthy human volunteers. 9 healthy human volunteers were included as part of physiological feasibility study. All participants had two ALA-care plasters administered on the chest after cleaning. One part of the skin was pretreated with microneedling, which perforates the epidermis with a depth of 0.30 mm. The time-to-sufficient signal was recorded for both untreated and microneedled ALA-care application. After induction mitoPO2 was varied using different FiO2 and the agreement between untreated and microneedled skin for mitoPO2 and mitoVO2 was recorded. Pre-treatment with microneedling induced reliable signal at 2 (IQR: 2-2) hours after topical ALA administration compared to 3 (IQR: 3-4) hours without pre-treatment (p = 0.02). The intraclass correlation of mitoPO2 simultaneously measured on microneedling and untreated skin was 0.892 (95%CI 0.821-0.936). MitoVO2 showed poor agreement between untreated and microneedling with an ICC of 0.316 (0.04-0.55). We demonstrate that pre-treatment with microneedling before topical application of 5-aminolevulinic acid enables obtaining a reliable and accurate mitoPO2 signal at least an hour faster than on untreated skin in our population of human volunteers. This potentially increases the applicability of mitoPO2 measurements in acute settings.Trial registration number: R21.106 (01-01-2022).</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"427-434"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}