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Preparation and Respirometric Assessment of Mitochondria Isolated from Skeletal Muscle Tissue Obtained by Percutaneous Needle Biopsy
Published on: February 7, 2015
Anesthesia-related morbidity and mortality after surgery for muscle biopsy in children with mitochondrial defects
Jacques Driessen1, Simone Willems, Sander Dercksen
1Department of Anesthesiology, Radboud University Medical Center, Nijmegen, The Netherlands. jj.driessen@anes.umcn.nl
Background:
Children with mitochondrial defects (MD) may have an increased risk for cardiorespiratory and neurological complications from anesthesia. The aim of this study was to determine the incidence of perioperative complications and adverse events in children with MD.
Methods:
We performed a retrospective review of the anesthesia, surgical and medical records of 155 children up to 10 years who underwent a diagnostic surgical muscle biopsy for suspected mitochondrial and muscle disorders between 1999 and 2003. The data of the 122 patients where a definite MD diagnosis was found were analyzed. Anesthesia was conducted according to the discretion of the attending staff. In children with MD the activity of the different complexes of the oxidative phosphorylation system was measured.
Results:
From the preoperative assessment, signs of encephalopathy were most frequent (n = 93), followed by muscle weakness (n = 32), lactic acidosis (n = 15), cardiomyopathy and/or conduction defects (n = 10) and chronic respiratory problems (n = 7). The mean age of the children with MD was 32.4 months (SD = 26.9). The mean duration of anesthesia was 36.0 min (SD = 12.6) and the mean length of stay in the recovery room was 33.0 min (SD = 24.0). There were no major changes in heart rate or blood pressure which required pharmacological intervention during anesthesia or postanesthesia care unit (PACU) stay. A short episode of SpO2 <80% with airway obstruction occurred once in the PACU. Biochemical analysis in the children with a MD showed an isolated deficiency of one of the five protein complexes of oxidative phosphorylation in 42 children, a combination of complex deficiencies in 41 and no definite localization in 39 children.
Conclusion:
With standard preoperative assessment, monitoring and anesthesia management, there were no major peroperative and postoperative anesthesia-related complications in children undergoing surgical muscle biopsy with a MD diagnosis.
Insights
Children with mitochondrial defects (MD) undergoing muscle biopsy had no major anesthesia complications. Standard care is safe for these children, minimizing risks during surgical procedures.
Area of Science:
- Pediatric Anesthesiology
- Mitochondrial Medicine
- Neuromuscular Disorders
Background:
- Children with mitochondrial defects (MD) face increased risks for cardiorespiratory and neurological issues during anesthesia.
- This study aimed to assess the incidence of perioperative complications in pediatric patients with MD.
Purpose of the Study:
- To determine the incidence of perioperative complications and adverse events in children with mitochondrial defects (MD) undergoing diagnostic surgical muscle biopsy.
- To evaluate the safety of standard anesthesia management in this vulnerable pediatric population.
Main Methods:
- Retrospective review of anesthesia, surgical, and medical records for 155 children (up to 10 years) with suspected mitochondrial and muscle disorders.
- Analysis focused on 122 patients with confirmed MD diagnoses, examining anesthesia practices and oxidative phosphorylation system activity.
- Data collected included patient demographics, anesthesia duration, recovery room stay, and perioperative events.
Main Results:
- Encephalopathy was the most frequent preoperative finding (n=93), followed by muscle weakness (n=32) and lactic acidosis (n=15).
- No major hemodynamic changes requiring intervention occurred during anesthesia or PACU stay; one instance of SpO2 <80% with airway obstruction was noted.
- Biochemical analysis revealed varying patterns of oxidative phosphorylation complex deficiencies.
Conclusions:
- Standard preoperative assessment, monitoring, and anesthesia management are safe for children with MD undergoing surgical muscle biopsy.
- No major peroperative or postoperative anesthesia-related complications were observed in this cohort.
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