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A new predictive equation for oxygen consumption in children and adults with congenital and acquired heart disease
  1. Michael D Seckeler,
  2. Russel Hirsch,
  3. Robert H Beekman III,
  4. Bryan H Goldstein
  1. The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  1. Correspondence to Dr Michael D Seckeler, Department of Pediatrics (Cardiology), The University of Arizona, 1501 N. Campbell Ave, PO Box 245073, Tucson, AZ 85724, USA; mseckeler{at}peds.arizona.edu

Abstract

Objective To develop a new predictive equation for oxygen consumption (VO2) in children and adults with congenital and acquired heart disease.

Methods We retrospectively reviewed data from 502 consecutive patients (age 0–59 years) undergoing cardiac catheterisation with measured VO2 (M-VO2) and compared M-VO2 with VO2 from the LaFarge equations (LF-VO2) in patients <3 years (Group 1) and ≥3 years (Group 2). Factors associated with inaccurate LF-VO2 were used to develop a new predictive equation, which was prospectively validated in 100 consecutive patients (age 0–59 years).

Results LF-VO2 was inaccurate in 42% of Group 1 (n=201) and 13% of Group 2 (n=301). Multivariable predictors of inaccurate LF-VO2 included age (OR 0.41, p=0.01) and single ventricle anatomy (OR 2.98, p=0.03) in Group 1 and anaemia (OR 0.84, p<0.001) in Group 2. Critical illness was borderline significant in both groups. The new predictive equation for VO2:Formula

Intraclass correlation between M-VO2 and the new predictive equation was good (r=0.53), whereas LF-VO2 was not (r=0.17). Bland-Altman analysis comparing M-VO2 with the new equation and with LF-VO2 demonstrated superiority of the new equation (mean bias 2.5 mL/min/m2 vs −5.0 mL/min/m2; limits of agreement −51.6, 56.5 vs −82.1, 72).

Conclusions VO2 derived from the LaFarge equations is frequently inaccurate, particularly in younger patients, and will lead to erroneous haemodynamic calculations. We developed and prospectively validated a new VO2 predictive equation for use in patients of all ages with congenital and acquired heart disease.

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