A Comparative Analysis of Ideal Body Weight Methods for Pediatric Mechanical Ventilation

Abstract

The majority of the subjects demonstrated a clinically important error between the actual body weight and the IBW. The percent error increased in subjects > 25 kg actual body weight. These data underline the importance of obtaining height measurements and calculated IBW in pediatric patients who are mechanically ventilated.

Understanding pediatric ventilation in the operative setting. Part II: Setting perioperative ventilation

“…Studies comparing methods of calculating IBW, however, suggest that actual body weight and IBW can differ considerably in children. 8,9 Calculation of IBW should therefore be limited to children above the age of 2 years. 9 Although there is no gold standard equation for calculating IBW in children, Ward et al found the McLaren-Read method fits, in children with PARDS between the age of 2 and 10 years, and particularly in children above the age of 10 years, where discrepancies between different calculation methods were most distinct.…”

“…Height, and therefore IBW, is accepted as a rough surrogate for TLC. Studies comparing methods of calculating IBW, however, suggest that actual body weight and IBW can differ considerably in children 8,9 . Calculation of IBW should therefore be limited to children above the age of 2 years 9 .…”

“…8,9 Calculation of IBW should therefore be limited to children above the age of 2 years. 9 Although there is no gold standard equation for calculating IBW in children, Ward et al found the McLaren-Read method fits, in children with PARDS between the age of 2 and 10 years, and particularly in children above the age of 10 years, where discrepancies between different calculation methods were most distinct. 10 The authors conclude that the McLaren-Read method is relatively easy to calculate using readily available growth charts that compare weight and height in relation to a child's age.…”

Actual Versus Ideal Body Weight: The Devil Is in the Details

“…By using 3 different methods to calculate ideal body weight, the investigators demonstrated that more than half of the subjects had clinically important differences between their actual and ideal weight, and all 3 methods for calculating ideal body weight produced similar differences. 3 Of greatest concern was that the difference between ideal and actual body weight was more disparate in subjects who were heavier. In the SEE THE ORIGINAL STUDY ON PAGE 1079 subjects who were heavier, this difference between ideal and actual body weight was of even more importance given the potential implications on tidal volume.…”