Kobayashi Daisuke, Zanaboni Dominic B, Glatz Andrew C, Balzer David
Division of Cardiology, Departments of Pediatrics, Washington University in St. Louis School of Medicine and St. Louis Children'S Hospital, One Children's Place, St. Louis, MO, 63110, USA.
Pediatr Cardiol. 2025 Feb 26. doi: 10.1007/s00246-025-03817-5.
Oxygen consumption (VO) is an essential component to calculate cardiac output using the Fick principle in the congenital cardiac catheterization laboratory (CCCL). Although VO can be measured, the value of VO is frequently assumed based on predictive equations. The objective of this study was to investigate current practice variation in measurement and estimation of VO in CCCL. This was a cross-sectional survey study conducted in January-February 2024. The survey (n = 114) was sent to one interventional cardiologist for each CCCL program in the United States utilizing REDCap. The responses were summarized in a descriptive fashion. Eighty eight programs completed the survey (response rate 77%). Only 13 (15%) programs measured VO, though 67 programs (76%) thought VO should be measured for all cases (n = 41) and selective cases (n = 26) and 17 programs thought assumed VO was satisfactory. When VO is referred from predictive equations, most programs primarily used LaFarge (n = 64, 73%), followed by Seckeler (n = 23, 26%). For patients aged < 3 years (where LaFarge equation does not provide VO2 value) in 64 programs using LaFarge, 16 used Seckeler and the remaining 48 programs used a wide range of arbitrary VO values. Most CCCL thought VO should be measured but only 13 (15%) programs actually measured VO in the United States. LaFarge remains frequently used as a predictive equation. There is no standardization of clinical practice in VO measurement/estimation among CCCL in the United States.
在先天性心脏导管实验室(CCCL)中,氧耗量(VO)是使用菲克原理计算心输出量的一个重要组成部分。虽然VO可以测量,但VO的值通常是基于预测方程来假定的。本研究的目的是调查CCCL中VO测量和估计方面当前的实践差异。这是一项于2024年1月至2月进行的横断面调查研究。该调查(n = 114)通过REDCap发送给美国每个CCCL项目的一名介入心脏病专家。以描述性方式总结了回复情况。88个项目完成了调查(回复率77%)。只有13个(15%)项目测量了VO,不过67个项目(76%)认为对于所有病例(n = 41)和选择性病例(n = 26)都应该测量VO,17个项目认为假定的VO是令人满意的。当从预测方程引用VO时,大多数项目主要使用拉法热方程(n = 64,73%),其次是塞克勒方程(n = 23,26%)。在使用拉法热方程的64个项目中,对于年龄<3岁的患者(拉法热方程无法提供VO2值),16个项目使用塞克勒方程,其余48个项目使用了广泛的任意VO值。大多数CCCL认为应该测量VO,但在美国只有13个(15%)项目实际测量了VO。拉法热方程仍然经常被用作预测方程。美国CCCL在VO测量/估计方面的临床实践没有标准化。