Abstract
Introduction: There are known sources of error in cardiac index calculated by the Fick method with LaFarge estimates of oxygen consumption (eFick CI) and in cardiac index measured by thermodilution (TDCI). In a large adult cohort, there was only modest correlation between eFick CI and TDCI. Hypothesis: Among pediatric patients undergoing cardiac catheterization, eFick CI and TDCI will differ by greater than 20% in greater than 10% of cases. Methods: We performed a single-center retrospective chart review of patients aged 3-18yrs who underwent cardiac catheterization with documented eFick CI and TDCI from 2004 to 2020. eFick CI was calculated using oxygen consumption estimated by the LaFarge equation. Results: Among 201 right heart catheterizations (mean age 12.2 yrs, SD 4.4yrs; 51% male) performed on 161 distinct patients, the most frequent diagnosis was cardiomyopathy, followed by congenital heart disease, and pulmonary hypertension. TDCI and eFick differed by >20% in 49% of catheterizations; further, eFick CI was systematically higher than TDCI, with mean difference +0.71L/min/m 2 , SD 1.07L/min/m 2 . In a multivariate linear regression analysis (Table 1), higher mean CI ((eFick CI + TDCI)/2), and older age were predictive of greater percent difference between eFick CI and TDCI; for each increase in mean CI by 1.0 L/min/m 2 , the expected percent difference in CI increased by 9.9% (p=0.000). Conclusions: In pediatric patients undergoing cardiac catheterization, eFick CI is systematically higher than TDCI and the difference between values is frequently >20%, which may have clinically significant implications. Discrepancies between eFick CI and TDCI increase at higher mean CI.
Published Version
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