OBJECTIVE: We sought to investigate the differences in assumed and measured oxygen consumption values for the determination of cardiac output by using the Fick principle in a pediatric population with congenital heart disease. METHODS: The patient population consisted of 143 patients with a mean age of 11.3 years (age range, 2 days to 23.8 years) undergoing cardiac catheterization during general anesthesia and with mechanical ventilation. Oxygen consumption was measured with a standard commercial analyzing system (Deltatrac II; Datex, Engström, Helsinki, Finland). Assumed oxygen consumption values were calculated according to the formulas of Krovetz and Goldbloom and LaFarge and Miettinen. Comparisons between measurements and assumptions were performed by Bland-Altman plots. Two-sided paired t tests were used to assess a difference of the assumed and measured values. RESULTS: The range of measured oxygen consumption values was between 55.2 and 249 mL . min -1 . m -2 . The Krovetz-Goldbloom formula led to systematically larger values compared with the measured values (P = .0001; mean difference of -53.3 mL . min -1 . m -2 ; 95% confidence interval, -56.7 to -49.8 mL . min -1 . m -2 ). The use of the LaFarge-Miettinen formula tends to overestimate oxygen consumption (P = .0037; mean difference of -15.9 mL . min -1 . m -2 ; 95% confidence interval, -26.5 to -5.4 mL . min -1 . m -2 ). A similarly poor agreement was found when analyzing a subgroup of 25 patients with Fontan-type circulation. CONCLUSION: The use of assumed instead of measured oxygen consumption values introduces large errors in the determination of cardiac output.
OBJECTIVE: We sought to investigate the differences in assumed and measured oxygen consumption values for the determination of cardiac output by using the Fick principle in a pediatric population with congenital heart disease. METHODS: The patient population consisted of 143 patients with a mean age of 11.3 years (age range, 2 days to 23.8 years) undergoing cardiac catheterization during general anesthesia and with mechanical ventilation. Oxygen consumption was measured with a standard commercial analyzing system (Deltatrac II; Datex, Engström, Helsinki, Finland). Assumed oxygen consumption values were calculated according to the formulas of Krovetz and Goldbloom and LaFarge and Miettinen. Comparisons between measurements and assumptions were performed by Bland-Altman plots. Two-sided paired t tests were used to assess a difference of the assumed and measured values. RESULTS: The range of measured oxygen consumption values was between 55.2 and 249 mL . min -1 . m -2 . The Krovetz-Goldbloom formula led to systematically larger values compared with the measured values (P = .0001; mean difference of -53.3 mL . min -1 . m -2 ; 95% confidence interval, -56.7 to -49.8 mL . min -1 . m -2 ). The use of the LaFarge-Miettinen formula tends to overestimate oxygen consumption (P = .0037; mean difference of -15.9 mL . min -1 . m -2 ; 95% confidence interval, -26.5 to -5.4 mL . min -1 . m -2 ). A similarly poor agreement was found when analyzing a subgroup of 25 patients with Fontan-type circulation. CONCLUSION: The use of assumed instead of measured oxygen consumption values introduces large errors in the determination of cardiac output.
Authors: Alexander R Opotowsky; Edward Hess; Bradley A Maron; Evan L Brittain; Anna E Barón; Thomas M Maddox; Laith I Alshawabkeh; Bradley M Wertheim; Meng Xu; Tufik R Assad; Jonathan D Rich; Gaurav Choudhary; Ryan J Tedford Journal: JAMA Cardiol Date: 2017-10-01 Impact factor: 14.676
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Authors: Zaher Fanari; Matthew Grove; Anitha Rajamanickam; Sumaya Hammami; Cassie Walls; Paul Kolm; Mitchell Saltzberg; William S Weintraub; Andrew J Doorey Journal: Del Med J Date: 2016-09
Authors: Zaher Fanari; Matthew Grove; Anitha Rajamanickam; Sumaya Hammami; Cassie Walls; Paul Kolm; Mitchell Saltzberg; William S Weintraub; Andrew J Doorey Journal: Cardiovasc Revasc Med Date: 2016-02-27
Authors: Maria Jesus Del Cerro; Shahin Moledina; Sheila G Haworth; Dunbar Ivy; Maha Al Dabbagh; Hanaa Banjar; Gabriel Diaz; Alexandria Heath-Freudenthal; Ahmed Nasser Galal; Tilman Humpl; Snehal Kulkarni; Antonio Lopes; Ana Olga Mocumbi; G D Puri; Beyra Rossouw; S Harikrishnan; Anita Saxena; Patience Udo; Lina Caicedo; Omar Tamimi; Ian Adatia Journal: Pulm Circ Date: 2016-03 Impact factor: 3.017