PMID- 37243747
OWN - NLM
STAT- Publisher
LR  - 20230527
IS  - 1432-1971 (Electronic)
IS  - 0172-0643 (Linking)
DP  - 2023 May 27
TI  - Measured Oxygen Consumption During Pediatric Cardiac Catheterization is More 
      Accurate than Assumed Oxygen Consumption.
LID - 10.1007/s00246-023-03186-x [doi]
AB  - 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) (rho(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) (rho(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.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Ralston, Bradford H
AU  - Ralston BH
AUID- ORCID: 0000-0002-0133-1755
AD  - Division of Cardiology, Children's National Hospital, Washington, DC, USA. 
      bradralston@gwu.edu.
AD  - 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.
FAU - Waberski, Andrew T
AU  - Waberski AT
AUID- ORCID: 0000-0002-0901-1342
AD  - Division of Anesthesiology, Pain, and Perioperative Medicine, Children's National 
      Hospital, Washington, DC, USA.
FAU - Kanter, Joshua P
AU  - Kanter JP
AUID- ORCID: 0000-0002-9773-4566
AD  - Division of Cardiology, Children's National Hospital, Washington, DC, USA.
FAU - Schick, Jacob W
AU  - Schick JW
AD  - Division of Anesthesiology, Pain, and Perioperative Medicine, Children's National 
      Hospital, Washington, DC, USA.
FAU - Downing, Tacy E
AU  - Downing TE
AUID- ORCID: 0000-0002-2577-0074
AD  - Division of Cardiology, Children's National Hospital, Washington, DC, USA.
LA  - eng
PT  - Journal Article
DEP - 20230527
PL  - United States
TA  - Pediatr Cardiol
JT  - Pediatric cardiology
JID - 8003849
SB  - IM
OTO - NOTNLM
OT  - Cardiac output
OT  - Congenital heart defects
OT  - Hemodynamic monitoring
OT  - Indirect calorimetry
EDAT- 2023/05/27 19:14
MHDA- 2023/05/27 19:14
CRDT- 2023/05/27 15:00
PHST- 2023/02/06 00:00 [received]
PHST- 2023/05/14 00:00 [accepted]
PHST- 2023/05/27 19:14 [medline]
PHST- 2023/05/27 19:14 [pubmed]
PHST- 2023/05/27 15:00 [entrez]
AID - 10.1007/s00246-023-03186-x [pii]
AID - 10.1007/s00246-023-03186-x [doi]
PST - aheadofprint
SO  - Pediatr Cardiol. 2023 May 27. doi: 10.1007/s00246-023-03186-x.