COSMOS: The metabolic response to major surgery
Research type
Research Study
Full title
Characterising the impact of Oxidative Stress & Mitochondrial function on Outcomes following major Surgery (COSMOS)
IRAS ID
214019
Contact name
Daniel S Martin
Contact email
Sponsor organisation
Royal Free London NHS Trust
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Many patients who undergo surgery suffer postoperative complications. These are diverse in nature, and may cause problems at the surgical site, such as infection or impaired wound healing, or in remote organs, resulting in pneumonia, kidney injury or delirium. Complications lead to prolonged hospital stay, shortened lifespan and reduced quality of life; and may sometimes spiral into critical illness, multi-organ failure and even death. Elucidating mechanisms underlying pathological responses to the challenge of major surgery may be the key to preventing these complications. Most of the energy that cells require to survive and function properly is produced by tiny ‘power stations’ that exist within them: the mitochondria. Surgery may cause a disruption of the mitochondrial environment, impairing their ability to produce energy, and even leading to their destruction. Impairment of mitochondrial function has been linked to worse outcomes in other serious conditions and we propose that it may also lead to worse outcomes following surgery.
We intend to measure markers of oxidative stress (in blood samples) and mitochondrial function (from a small muscle biopsy) prior to and following elective major surgery. We will compare these measures between patients who develop complications and those who do not. We will also investigate whether these measures correlate with current measures of preoperative “fitness”, determined by cardiopulmonary exercise testing. We aim to shed light on cellular mechanisms underlying the development of complications following major surgery, and to identify targets for their prevention and treatment.
The results of this study may identify whether oxidative stress leads to mitochondrial dysfunction during major surgery, and if this contributes to adverse outcomes. It could highlight important processes that are amenable to drugs, which may allow us to reduce harm to high risk patients undergoing operations in the future.
REC name
London - West London & GTAC Research Ethics Committee
REC reference
17/LO/0152
Date of REC Opinion
26 Apr 2017
REC opinion
Further Information Favourable Opinion