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Indirect Calorimetry Overestimates Oxygen Consumption in Young Children : Caution is Advised Using Direct Fick Method as a Reference Method in Cardiac Output Comparison Studies

Sigurdsson, Theodor S. LU and Lindberg, Lars LU (2019) In Pediatric Cardiology
Abstract

Direct Fick method is considered a standard reference method for estimation of cardiac output. It relies on indirect calorimetry to measure oxygen consumption. This is important as only a minor measurement error in oxygen consumption can result in false estimation of cardiac output. A number of studies have shown that indirect calorimetry overestimates oxygen consumption in adults. The aim of this prospective single center observational method comparison study was to compare the determination of oxygen consumption by indirect calorimetry and reverse Fick method in pediatric patients. Forty-two children mean age 352 days (range 30 to 1303 days) and mean weight 7.1 kg (range 2.7–13.6 kg) undergoing corrective cardiac surgery were included... (More)

Direct Fick method is considered a standard reference method for estimation of cardiac output. It relies on indirect calorimetry to measure oxygen consumption. This is important as only a minor measurement error in oxygen consumption can result in false estimation of cardiac output. A number of studies have shown that indirect calorimetry overestimates oxygen consumption in adults. The aim of this prospective single center observational method comparison study was to compare the determination of oxygen consumption by indirect calorimetry and reverse Fick method in pediatric patients. Forty-two children mean age 352 days (range 30 to 1303 days) and mean weight 7.1 kg (range 2.7–13.6 kg) undergoing corrective cardiac surgery were included in the study. The mean (standard deviation) oxygen consumption by reverse Fick method was 43.5 (16.2) ml/min and by indirect calorimetry 49.9 (18.8) ml/min (p < 0.001). Indirect calorimetry overestimated the reverse Fick oxygen consumption by 14.7%. Bias between methods was 6.5 (11.3) ml/min, limits of agreement (LOA) − 15.7 and 28.7 ml/min and percentage error of 47.7%. A significant bias and large percentage error indicates that the methods are not interchangeable. Indirect calorimetry and the direct Fick method should be used with caution as a reference method in cardiac output comparison studies in young children.

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author
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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac output, Cardiac surgery, Children, Indirect calorimetry, Oxygen consumption, Reverse fick method
in
Pediatric Cardiology
publisher
Springer
external identifiers
  • pmid:31741015
  • scopus:85075168732
ISSN
0172-0643
DOI
10.1007/s00246-019-02238-5
language
English
LU publication?
no
id
d667e5b4-cec6-40fe-8744-1dbd4b5f23ac
date added to LUP
2019-12-06 12:28:03
date last changed
2024-05-15 03:13:06
@article{d667e5b4-cec6-40fe-8744-1dbd4b5f23ac,
  abstract     = {{<p>Direct Fick method is considered a standard reference method for estimation of cardiac output. It relies on indirect calorimetry to measure oxygen consumption. This is important as only a minor measurement error in oxygen consumption can result in false estimation of cardiac output. A number of studies have shown that indirect calorimetry overestimates oxygen consumption in adults. The aim of this prospective single center observational method comparison study was to compare the determination of oxygen consumption by indirect calorimetry and reverse Fick method in pediatric patients. Forty-two children mean age 352 days (range 30 to 1303 days) and mean weight 7.1 kg (range 2.7–13.6 kg) undergoing corrective cardiac surgery were included in the study. The mean (standard deviation) oxygen consumption by reverse Fick method was 43.5 (16.2) ml/min and by indirect calorimetry 49.9 (18.8) ml/min (p &lt; 0.001). Indirect calorimetry overestimated the reverse Fick oxygen consumption by 14.7%. Bias between methods was 6.5 (11.3) ml/min, limits of agreement (LOA) − 15.7 and 28.7 ml/min and percentage error of 47.7%. A significant bias and large percentage error indicates that the methods are not interchangeable. Indirect calorimetry and the direct Fick method should be used with caution as a reference method in cardiac output comparison studies in young children.</p>}},
  author       = {{Sigurdsson, Theodor S. and Lindberg, Lars}},
  issn         = {{0172-0643}},
  keywords     = {{Cardiac output; Cardiac surgery; Children; Indirect calorimetry; Oxygen consumption; Reverse fick method}},
  language     = {{eng}},
  publisher    = {{Springer}},
  series       = {{Pediatric Cardiology}},
  title        = {{Indirect Calorimetry Overestimates Oxygen Consumption in Young Children : Caution is Advised Using Direct Fick Method as a Reference Method in Cardiac Output Comparison Studies}},
  url          = {{http://dx.doi.org/10.1007/s00246-019-02238-5}},
  doi          = {{10.1007/s00246-019-02238-5}},
  year         = {{2019}},
}