To ascertain differences in mitochondrial and microcirculatory parameters between healthy older adults (> 65 years and ASA1-2) and more vulnerable elderly patients (> 65 years and ASA 3-4).
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
ouderdom en kwetsbaarheid
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary parameters are mitochondrial oxygen tension (mitoPO2), mitochondrial
oxygen consumption (mitoVO2) and microcirculatory perfusion, with the latter
encompassing total and perfused vessel density, proportion of perfused vessels,
microvascular flow index, and vessel diameters
Secondary outcome
- MitoPO2 (mmHg).
- MitoPO2 after extercise (1MSTS test)
- metabolic frailty according the fried frailty phenotype assessment
- Mitochondrial function in platelets.
- Mitochondrial DNA in plasma as a marker of mitochondrial damage
- Mitochondrial function in peripheral blood mononuclear cells
- Post-operative complications
- Length of hospital stay
- Readiness for hospital discharge (using the RN-RHDS and the PT-RHDS) (30)
- Postoperative factors: patient outcome (according to Clavien-Dindo
complica-tion classification). (31)
Background summary
Rationale: The study aims to address the growing need for improved
perioperative care in frail elderly patients, acknowledging the challenges
posed by their reduced metabolic capacity and increased risk of postoperative
complications. In particular, this study is the first step in our goal to
improve preoperative screening, and subsequent patient management, by
incorporating mitochondrial and microcirculatory function measurements. The
focus is on researching alterations in mitochondrial function by means of the
Cellular Oxygen METabolism (COMET) monitor, for measuring mitochondrial
oxygenation and oxygen consumption in vivo. This is crucial as mitochondrial
dysfunction is believed to play a key role in the pathophysiology of aging and
frailty. The mitochondrial measurements will be complemented by measurement of
microcirculatory parameters in order to get insight in what has recently been
defined as the *critical unit*, emphasizing the coalescence and interplay
between mitochondria and microcirculation. The hypothesis is that we will find
differences in the critical unit between healthy older adults and more
vulnerable and frail elderly patients, which can potentially be useful in
decision making and patient management.
Study objective
To ascertain differences in mitochondrial and microcirculatory parameters
between healthy older adults (> 65 years and ASA1-2) and more vulnerable
elderly patients (> 65 years and ASA 3-4).
Study design
A single-center observational study at Erasmus Medical Center's pre-operative
clinic
Study burden and risks
Participants will undergo non-invasive procedures with minimal risks, such as
mild skin irritation. The study does not offer direct benefits to the
participants but aims to enhance perioperative care for the elderly. The burden
includes additional blood sampling and standard perioperative measurements. The
risks are considered low, mainly involving temporary skin discomfort and
standard blood sampling risks. This study is particularly pertinent to the
elderly undergoing surgery, aiming to improve their care by better
understanding mitochondrial function and microcirculation in the context of
frailty and perioperative management
Dr. Molewaterplein 40 40
Rotterdam 3015 GD
NL
Dr. Molewaterplein 40 40
Rotterdam 3015 GD
NL
Listed location countries
Age
Inclusion criteria
> 65 years of age at start of the study
Planned for elective surgery.
Exclusion criteria
• Not able to read or speak Dutch or English;
• Skin defects at the measurement side;
• Mentally disabled;
• Porphyria;
• Presence of mitochondrial disease;
• Medically unsave, or pfysically unable to perform a sit-to-stand test
according to own justment or the justment of the medical staff or the research
team assosiated with this studie
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL86239.078.24 |