Accuracy of Weight and Height Estimation in an Intensive Care Unit

Maskin, Luis Patricio; Attie, Shiry; Setten, Mariano; Rodríguez, Pablo; Bonelli, Ignacio; Stryjewski, Martín E.; Valentini, Ricardo

doi:10.1177/0310057x1003800519

Cited by 61 publications

(39 citation statements)

References 18 publications

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“…This is especially true outside of the surgical ICU (i.e., emergency department, postanesthesia recovery room or medical ICU) because surgical ICUs are more likely to have height and weight measurements due to the operative record [58]. In addition, visual estimation of patient height and weight is known to be inaccurate [109–111], and shorter patients, often women, tend to be more severely affected [54, 112]. The ability to rapidly calculate PBW at the bedside is important.…”

Section: Challenges and Controversy To The Use Of Protective Ventimentioning

confidence: 99%

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Lipes

Bojmehrani

Lellouche

2012

Critical Care Research and Practice

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Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges.

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Section: Challenges and Controversy To The Use Of Protective Ventimentioning

confidence: 99%

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Lipes

Bojmehrani

Lellouche

2012

Critical Care Research and Practice

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“…[12] Drug dosage and infusion rates in adults are usually based on body weight. [345] One of the most common methods for arriving at a dosage is weight estimation. [678] Measuring weight may be impossible, especially for critically ill-patients and emergency condition and before anesthesia.…”

Section: Introductionmentioning

confidence: 99%

“…[121314] In the operating room, with stressful condition, patients may frequently arrive unconscious or with emergency condition and accurate weight measurement can be difficult or impossible to obtain. [41214]…”

Section: Introductionmentioning

confidence: 99%

Accuracy of estimation of total body weight by legs and head weight measuring and comparison method in the anesthetized patients

Nasiri

2013

Anesth Essays Res

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Context:Accurate patient weight is an important factor in the emergency and operating room departments.Aims:The aim of this study is to determine the accuracy of estimation of total body weight by legs and head weight measuring and comparison method in the anesthetized patients.Settings and Design:Education of hospitals, Mazandaran University of Medical Sciences, prospective, observational study.Subjects and Methods:This is prospective observational study. Nursing staff were asked to estimated weight that knows about a similar person weight on the operating room and matched together, then told his/her guests. They were measured total body weight before anesthesia and then patient head and legs weight after anesthesia. The main outcome was mean weight of these methods and percent accuracy in weight estimation for each group recorded.Statistical Analysis:Descriptive statistically used.Results:Overall, 57.3% (243/425) of operating personnel estimations were equal with actual weight. 35.4% (150/425) of the estimations were less 10 kg than the actual weight and only 7.3 (31/425) of the estimations were above 5 kg of actual weight. The accuracy of overall estimations by operating personnel and its comparison to the accuracy of legs weight, head, and sum weight by a similar method is demonstrated.Conclusions:Despite having no formula in the critical intensive care and anesthesia region for estimation anesthetized, for comatose patient weight. We can use this formula, but where possible, should be based on measured weight for drug dose calculation and this is not possible, combination of these formulas is suitable.

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“…The ICON secondary analysis used measured and estimated BMI, a practice similar to what routinely happens in an ICU as weight and height may not be practically or accurately measurable (3,4). In general, measurement errors in weight estimation in the ICU are common and of such magnitude as to potentially alter the BMI category (3).…”

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confidence: 99%

“…Furthermore, overestimation of BMI in older adults may occur due to decreased height measurements related to vertebral fractures, intervetebral disc compression, kyphosis, scoliosis, and being bedridden (16). In the ICU, height or weight measurements are commonly inaccurate, which can result in misclassifications in the extremes of BMI (3,4).…”

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confidence: 99%

The Body Mass Index Paradox*

Christopher

2015

Critical Care Medicine

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T he intensive care over nations (ICON) audit was an ambitious undertaking encompassing 10,069 patients in 730 ICUs in 84 countries mobilized for a 10-day period in 2012 for the purpose of understanding worldwide critical care delivery and epidemiology (1). The ICON investigators have performed an important real-world secondary analysis of 8,829 ICON patients had body mass index (BMI) recorded and were studied to determine the association of BMI and 60-day in-hospital death (2). In the ICON secondary analysis, 19.1% had BMI greater than or equal to 30 kg/ m 2 highlighting the pervasiveness of high BMI worldwide in the ICU. In this secondary analysis, the ICON investigators found that in adjusted Cox regression models, lower mortality was present in patients with a higher BMI, whereas mortality was increased with the lowest BMI consistent with the obesity paradox.The ICON secondary analysis used measured and estimated BMI, a practice similar to what routinely happens in an ICU as weight and height may not be practically or accurately measurable (3, 4). In general, measurement errors in weight estimation in the ICU are common and of such magnitude as to potentially alter the BMI category (3). Estimated data in the ICON secondary analysis are likely occurring at random and or at low frequency as the results are robust and consistent with other published observations in critical illness (5, 6).Previous studies in the critically ill show that high BMI is associated with increased ICU and/or in-hospital mortality, no difference in mortality and also improved mortality relative to nonobese patients (5). Similar to the important work of the ICON investigators, a nationally representative Dutch study shows improved mortality in the obese critically ill (6). In a study of 6,518 ICU patients, our group confirmed that the association between BMI greater than or equal to 30.0 kg/m 2 and decreased mortality is present but is confounded by nutrition status (5). Furthermore, in ICU patients with greater than or equal to 30.0 kg/m 2 , our group found that malnourished patients have decreased survival when compared with those without malnutrition (5).To put the ICON secondary analysis into context, it is helpful to understand what BMI measures and how it was derived. BMI is an anthropometric measurement derived in the 1830s by Adolphe Quetelet, a polymath who excelled at mathematics, sociology, statistics, and astronomy (7). The Quetelet Index (weight [kg]/height [m 2 ]) was derived by hand calculations from best fit observations of growth data from children 1 year old until puberty. These data were extrapolated to adults with normal body frames at a time when average height was 5.5 feet, the mean age of death was 47, and obesity was scarcely an issue (7,8). In 1972, the performance of the Quetelet Index was found to be at least as good as any other relative weight index as an indicator of relative obesity (9) and renamed the BMI. Because of its simplicity, ease of implementation, and reliability (10), BMI was widely adopted.Altho...

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Accuracy of Weight and Height Estimation in an Intensive Care Unit

Cited by 61 publications

References 18 publications

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Accuracy of estimation of total body weight by legs and head weight measuring and comparison method in the anesthetized patients

The Body Mass Index Paradox*

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