Significant Practice Variation in Oxygen Consumption Values in Congenital Cardiac Catheterization: Cross Sectional Survey in the United States.

Oxygen consumption (VO2) is an essential component to calculate cardiac output using the Fick principle in the congenital cardiac catheterization laboratory (CCCL). Although VO2 can be measured, the value of VO2 is frequently assumed based on predictive equations. The objective of this study was to investigate current practice variation in measurement and estimation of VO2 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 VO2, though 67 programs (76%) thought VO2 should be measured for all cases (n = 41) and selective cases (n = 26) and 17 programs thought assumed VO2 was satisfactory. When VO2 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 VO2 values. Most CCCL thought VO2 should be measured but only 13 (15%) programs actually measured VO2 in the United States. LaFarge remains frequently used as a predictive equation. There is no standardization of clinical practice in VO2 measurement/estimation among CCCL in the United States.