Measured Oxygen Consumption During Pediatric Cardiac Catheterization is More Accurate than Assumed Oxygen Consumption.

Autor: Ralston BH; Division of Cardiology, Children's National Hospital, Washington, DC, USA. bradralston@gwu.edu.; Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, 900 23rd St. NW, Washington, DC, 20037, USA. bradralston@gwu.edu., Waberski AT; Division of Anesthesiology, Pain, and Perioperative Medicine, Children's National Hospital, Washington, DC, USA., Kanter JP; Division of Cardiology, Children's National Hospital, Washington, DC, USA., Schick JW; Division of Anesthesiology, Pain, and Perioperative Medicine, Children's National Hospital, Washington, DC, USA., Downing TE; Division of Cardiology, Children's National Hospital, Washington, DC, USA.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2024 Oct; Vol. 45 (7), pp. 1466-1474. Date of Electronic Publication: 2023 May 27.
DOI: 10.1007/s00246-023-03186-x
Abstrakt: When calculating cardiac index (C.I.) by the Fick method, oxygen consumption (VO 2 ) is often unknown, so assumed values are typically used. This practice introduces a known source of inaccuracy into the calculation. Using a measured VO 2 (mVO 2 ) from the CARESCAPE E-sCAiOVX module provides an alternative that may improve accuracy of C.I. calculations. Our aim is to validate this measurement in a general pediatric catheterization population and compare its accuracy with assumed VO 2 (aVO 2 ). mVO 2 was recorded for all patients undergoing cardiac catheterization with general anesthesia and controlled ventilation during the study period. mVO 2 was compared to the reference VO 2 (refVO 2 ) determined by the reverse Fick method using cardiac MRI (cMRI) or thermodilution (TD) as a reference standard for measurement of C.I. when available. 193 VO 2 measurements were obtained, including 71 with a corresponding cMRI or TD measure of cardiac index for validation. mVO 2 demonstrated satisfactory concordance and correlation with the TD- or cMRI-derived refVO 2 (ρ c  = 0.73, r 2  = 0.63) with a mean bias of - 3.2% (SD ± 17.3%). Assumed VO 2 demonstrated much weaker concordance and correlation with refVO 2 (ρ c  = 0.28, r 2  = 0.31) with a mean bias of + 27.5% (SD ± 30.0%). Subgroup analysis of patients < 36 months of age demonstrated that error in mVO 2 was not significantly different from that observed in older patients. Many previously reported prediction models for assuming VO 2 performed poorly in this younger age range. Measured oxygen consumption using the E-sCAiOVX module is significantly more accurate than assumed VO 2 when compared to TD- or cMRI-derived VO 2 in a pediatric catheterization lab.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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