CARDIOPULMONARY MONITORING: Edited by Jan BakkerMonitoring mitochondrial PO2: the next stepMik, Egbert G.a; Balestra, Gianmarco M.a,b; Harms, Floor A.aAuthor Information aLaboratory for Experimental Anesthesiology, Department of Anesthesiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands bDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland Correspondence to Egbert G. Mik, MD, PhD, Department of Anesthesiology, Erasmus MC – University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. Tel: +31 10 703 34 58; e-mail: [email protected] Current Opinion in Critical Care: June 2020 - Volume 26 - Issue 3 - p 289-295 doi: 10.1097/MCC.0000000000000719 Buy Metrics Abstract Purpose of review To fully exploit the concept of hemodynamic coherence in resuscitating critically ill one should preferably take into account information about the state of parenchymal cells. Monitoring of mitochondrial oxygen tension (mitoPO2) has emerged as a clinical means to assess information of oxygen delivery and oxygen utilization at the mitochondrial level. This review will outline the basics of the technique, summarize its development and describe the rationale of measuring oxygen at the mitochondrial level. Recent findings Mitochondrial oxygen tension can be measured by means of the protoporphyrin IX-Triplet State Lifetime Technique (PpIX-TSLT). After validation and use in preclinical animal models, the technique has recently become commercially available in the form of a clinical measuring system. This system has now been used in a number of healthy volunteer studies and is currently being evaluated in studies in perioperative and intensive care patients in several European university hospitals. Summary PpIX-TSLT is a noninvasive and well tolerated method to assess aspects of mitochondrial function at the bedside. It allows doctors to look beyond the macrocirculation and microcirculation and to take the oxygen balance at the cellular level into account in treatment strategies. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.