Measurement of Oxygen Consumption in Critically Ill Children: Breath-by-Breath Method vs Mass Spectrometry

Guo, Long; Cui, Yong; Bobhate, Prashant; Kumar, Shine; Jain, Shreepal; Elgendi, Mohamed; Pharis, Scott; Ryerson, Lindsay; Adatia, Ian

doi:10.4037/ajcc2016897

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Pediatric Critical Care| May 01 2016

Measurement of Oxygen Consumption in Critically Ill Children: Breath-by-Breath Method vs Mass Spectrometry

Long Guo, MD;

Long Guo, MD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Yong Cui, MD;

Yong Cui, MD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Prashant Bobhate, MD;

Prashant Bobhate, MD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Shine Kumar, MBBS;

Shine Kumar, MBBS

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Shreepal Jain, MD;

Shreepal Jain, MD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Mohamed Elgendi, PhD;

Mohamed Elgendi, PhD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Scott Pharis, MD;

Scott Pharis, MD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Lindsay Ryerson, MD;

Lindsay Ryerson, MD

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

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Ian Adatia, MBChB

Long Guo, Yong Cui, Prashant Bobhate, Shine Kumar, and Shreepal Jain were pulmonary hypertension service clinical research fellows; Scott Pharis was a pediatric cardiology fellow; Lindsay Ryerson is an assistant professor of pediatrics and a pediatric cardiac intensivist; and Ian Adatia is a professor of pediatrics, director of the pediatric pulmonary hypertension service, and a cardiac intensivist in the pediatric cardiac critical care unit at Stollery Children’s Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Cui is now a cardiac surgeon, Changhai Hospital, Second Military Medical University, Shanghai, People’s Republic of China. Pharis is now a staff pediatric cardiologist, Royal University Hospital, Saskatoon, Saskatchewan, Canada. Mohamed Elgendi is a postdoctorate research fellow, Department of Mathematics and Computing Science, University of Alberta, Edmonton, Canada.

Corresponding author: Ian Adatia, 3A3.42 Walter C. Mackenzie Health Sciences Center, 8440 112 St, Edmonton, Alberta, CanadaT6G 2B7 (e-mail: [email protected]).

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Am J Crit Care (2016) 25 (3): 243–248.

https://doi.org/10.4037/ajcc2016897

Background

Measurement of oxygen consumption (Vȯ₂) is difficult in children but is essential to calculate cardiac index and systemic vascular resistance.

Objective

To compare measurements of Vȯ₂ using respiratory mass spec trometry and the breath-by-breath method.

Methods

Vȯ₂ was measured simultaneously and continuously for 10 minutes by using respiratory mass spectrometry and the breath-by-breath method in children receiving mechanical ventilation via cuffed endotracheal tubes.

Results

Sixteen children (7 boys; median [range]: age, 1.5 [0.2–6] years; weight, 11.5 [2.8–23.5] kg; body surface area, 0.55 [0.18–0.98] m²) were studied. The correlation between measurements of Vȯ₂ by the 2 methods was good (R = 0.924). Mean Vȯ₂ measured by mass spectrometry was 63 (95% CI, 47–78) mL/min vs 65 (95% CI, 47–83) mL/min measured by the breath-by-breath method. The mean Vȯ₂ difference between the 2 methods was 3 (95% CI, −9 to 5) mL/min and statistically insignificant. Bland-Altman analysis showed that the 95% limits of agreement were between −28 and +23. Cardiac index did not differ significantly when calculated using Vȯ₂ measured with one method or the other (mean difference, 0.1; 95% CI, −0.2 to 0.3).

Conclusions

Measurements of Vȯ₂ did not differ between mass spectrometry and the breath-by-breath method. Use of the breath-by-breath method may facilitate calculation of cardiac index and systemic vascular resistance in critically ill children.

2016

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