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Estimation of the inferior caval vein saturation using high-fidelity non-invasive haemodynamic values and validation of modelled estimates

Published online by Cambridge University Press:  12 March 2024

Rohit S. Loomba Open the ORCID record for Rohit S. Loomba [Opens in a new window] ,
Saul Flores Open the ORCID record for Saul Flores [Opens in a new window] ,
Juan S. Farias Open the ORCID record for Juan S. Farias [Opens in a new window] ,
Enrique G. Villarreal Open the ORCID record for Enrique G. Villarreal [Opens in a new window]  and
Alex Constas
Rohit S. Loomba
Affiliation:
Division of Pediatric Cardiac Critical Care, Advocate Children’s Hospital, Oak Lawn, IL, USA Department of Pediatrics, Chicago Medical School/Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
Saul Flores
Affiliation:
Section of Critical Care Medicine and Cardiology, Texas Children’s Hospital, Houston, TX, USA Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Juan S. Farias*
Affiliation:
Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO, USA
Enrique G. Villarreal
Affiliation:
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL, Mexico
Alex Constas
Affiliation:
Division of Pediatric Cardiac Critical Care, Advocate Children’s Hospital, Oak Lawn, IL, USA
*
Corresponding author: J. S. Farias; Email: jsfariast@gmail.com
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Abstract

Objectives:

Monitoring venous saturation allows identification of inadequate systemic oxygen delivery. The aim was to develop a model using non-invasive haemodynamic variables to estimate the inferior caval vein saturation and to determine its prognostic utility.

Methods:

This is a single-centre, retrospective study. A Bayesian Pearson’s correlation was conducted to model the inferior caval vein saturation. Next, a Bayesian linear regression was conducted for data from all the patients and from only those with parallel circulation. Venous saturation estimations were developed. The correlation of these estimates to the actual inferior caval vein saturation was assessed. The resulting models were then applied to two validation cohorts: biventricular circulation (arterial switch operation) and parallel circulation (Norwood operation).

Results:

One hundred and thirteen datasets were collected across 15 patients. Of which, 65% had parallel circulation. In all patients, the measured and estimated inferior caval vein saturations had a moderate and significant correlation with a coefficient of 0.64. In patients with parallel circulation, the measured and estimated inferior caval vein saturation had a moderate and significant correlation with a coefficient of 0.61. In the biventricular circulation cohort, the estimated inferior caval vein saturation had an area under the curve of 0.71 with an optimal cut-off of 49. In the parallel circulation cohort, the estimated interior caval vein saturation had an area under the curve of 0.83 with an optimal cut-off of 24%.

Conclusion:

The inferior caval vein saturation can be estimated utilising non-invasive haemodynamic data. This estimate has correlation with measured inferior caval vein saturations and offers prognostic utility.

Keywords

Paediatric ICUoxygen saturationnear-infrared spectroscopypulse oximetrycardiac output
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 6
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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