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The goal of the present study was to propose a set of preliminary regional diagnostic reference levels (DRLs) for paediatric interventional cardiology procedures in Latin America and the Caribbean countries, classified by age and weight groups. The study is conducted in the framework of the OPRIPALC programme coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency. The first step of the programme was focused on paediatric interventional cardiology. Dose data from diagnostic and therapeutic procedures were collected between December 2020 and December 2021. Regional DRLs have been set as the 3rd quartile of patient dose data (kerma area-product) collected in 18 hospitals from 10 countries in an initial sample of 968 procedures. DRLs have been set for four age bands and five weight ranges. The values obtained for the four age bands (<1 year, 1 to <5 years, 5 to <10 years and 10 to <16 years) have been 2.9; 6.1; 8.8 and 14.4 Gy.cm2 for diagnostic procedures, and 4.0, 5.0, 10.0 and 38.1 Gy.cm2 for therapeutic procedures, respectively. The values obtained for the five weight bands (<5 kg, 5 to <15 kg, 15 to <30 kg, 30 to <50 kg and 50 to <80 kg) have been 3.0, 4.5, 8.1, 9.2 and 26.8 Gy.cm2 for diagnostic procedures and 3.7, 4,3, 7.3, 16.1 and 53.4 Gy.cm2 for therapeutic procedures, respectively. While initial data were collected manually as patient dose management systems were not available in most of the hospitals involved in the programme, a centralized automatic dose management system for the collection and management of patient dose indicators has now been introduced and is envisaged to increase the sample size. The possibility of alerting on high dose values and introducing corrective actions will help in optimization.

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