Six commonly used empirical body surface area formulas disagreed in young children undergoing corrective heart surgery

Abstract

Aim Formulas for empirical body surface area (BSA), which is used to estimate body size and standardise physiological parameters, may disagree in children. We compared six commonly used BSA formulas—Du Bois, Boyd, Costeff, Haycock, Meban and Mosteller—in a surgical cohort. Methods This retrospective single‐centre cohort study comprised 68 children who had corrective heart surgery at Skåne University Children's Hospital, Lund, Sweden, from February 2010 to March 2017. Results The children (51% female) underwent surgery at a mean weight of 7.0 kilograms (range 2.7‐14.1 kg) and a mean age 11 months (range 0‐43 months). All the BSA formulas showed good correlation with mean BSA, but there were considerable variations between them. Mosteller's formula was exactly the same as the mean BSA (bias 0.000). The Du Bois and Boyd formulas had the largest mean BSA deviations (bias −0.012 and 0.015). Costeff's formula showed good agreement with mean BSA, Haycock's formula showed minimal overestimation and Meban's formula demonstrated a systemic error in older children. Conclusion Commonly used BSA formulas did not agree in young children undergoing heart surgery, but they were all close to the overall mean of the six formulas, with the Mosteller formula producing the same value.

Reference Values for Ventricular Volumes and Pulmonary Artery Dimensions in Pediatric Patients with Transposition of the Great Arteries After Arterial Switch Operation

“…This is a retrospective study, but consecutive nonselected patients were included. The number of boys was higher than the number of girls, which is related to the known male predominance of TGA 17 …”

“…BSA was calculated with the Mosteller formula, and we do not know if the results from the regression analysis would have been similar if we had used a different BSA formula. However, it has recently been shown that the Mosteller formula provides the most accurate estimate of BSA in young children with congenital heart disease 17 . The fact that BSA is a function of height and weight implies that there is some redundancy in the investigated influence variables, which is expressed in the high correlations between these three variables.…”

Evaluation of nine formulas for estimating the body surface area of children with hematological malignancies

“…The Mosteller formula has been studied by several papers since it was established in 1987 ( 3 , 27 , 28 ). The greatest competitive advantage of the Mosteller formula is its conciseness.…”

Indexing haemodynamic variables in young children

“…Indexing is also complicated by the fact that children have a relatively larger body surface area (BSA) compared with body weight (BW) than adults, resulting in a non‐linear‐indexed haemodynamic variables 5 . Empirical formulas used to determine BSA in children often disagree in their calculations, adding to possible errors regarding estimations of indexed haemodynamic variables 6 …”

“…used to determine BSA in children often disagree in their calculations, adding to possible errors regarding estimations of indexed haemodynamic variables. 6 In 1963, Jegier and colleges published their landmark paper using dye dilution method, on the relationship between cardiac output (CO) and body size, comparing indexing with BSA and BW. 7 They found that although both size variables had a similar correlation with CO, there was a significant difference between age groups when BSA was used for CO indexing.…”