Optimal depth for left atrial pressure monitoring in pediatric open-heart surgery

Abstract

Abstract Background Monitoring the left atrial pressure (LAP) is an important perioperative management tool for maintaining adequate cardiac output. This study aimed to devise a simple formula of left atrial catheterization to quantify the LAP in infants based on strongly correlated demographic and clinical characteristics. Methods 62 open-heart surgery infant patients, aged ≤ 1 year, who underwent right internal jugular vein (RIJV) catheterization to monitor the LAP, were enrolled in this study. Pearson correlation coefficient and multiple regression analysis were used to determine the association between the optimal depth and characteristics. A new simple formula was developed using regression analysis to predict the depth for the LAP measurement. Results The participants comprised 39 (62.9%) males and 23 (37.1%) females, of which 10 (16.1%) were preterm. The average age was 4.3 months; average weight, 5.4 kg; and average height, 60.0 cm. Age, height, and weight were strongly associated with the optimal depth, with height having the highest corrected determination coefficient (R2 = 0.832) and the most significant difference in multiple regression model (P < 0.001). Thus, we established a new height-based formula: depth (cm) = 5 + 0.1 × height (cm). The proportion of optimal depth determined by the new simplified formula was 88.7%. Conclusions Height was the most significant individual predictor of optimal depth in this study. The novel formula, depth = 5.0 + 0.1 × height (cm), is feasible and can be used to determine the optimal depth for monitoring the LAP via RIJV catheterization in pediatric open-heart surgery.