Two methods for estimating body surface area in adult amputees

Colangelo, Philip; Welch, Dennis W.; Rich, Darryl S.; Jeffrey, Louis P.

doi:10.1093/ajhp/41.12.2650

Cited by 10 publications

(7 citation statements)

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“…The BSA of a person with LLA was calculated after considering the percentage of amputated limbs. 20 LLA group BSA [m 2 ] = (body height [cm] 0.725 ) × (estimated bodyweight [kg] 0.425 ) × (0.007184) × (1 – (% BSA), where the estimated bodyweight [kg] = (current weight [kg])/(1 – p), in which p is the ratio of the amputated limb to the total body weight; % P was 12.8% for transfemoral amputation (TFA) and 4.4% for transtibial amputation (TTA), 29 and the estimated BSA ratio (% BSA) presented by Colangelo et al 30 was 21.04% for TFA and 9.15% for TTA.…”

Section: Methodsmentioning

confidence: 99%

Thermoregulatory responses in persons with lower-limb amputation during upper-limb endurance exercise in a hot and humid environment

Fukuhara

Mikami

Hasegawa

et al. 2021

Prosthetics &Amp; Orthotics International

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Background: Persons with an amputation may have an increased heat strain due to reduced surface area. However, there is limited evidence on the thermoregulatory responses in persons with lower-limb amputation (LLA). Although a previous study reported no difference in their rectal temperatures (Tres) in a hot environment, suggesting compensatory sweating of the intact limb, we examined the thermoregulatory responses of such persons in a hot and humid environment. Objective: To compare the thermoregulatory responses-through changes in Tre, sweat, and oxygen uptake ( VO 2 )-between persons with LLA and able-bodied (AB) individuals, in hot and humid environments. Study design: A nonrandomized control trial. Methods: Nine AB men (AB group) and nine persons with LLA group performed the arm ergometer exercise at 60% peak power output intensity for 60 min in a hot and humid environment, and they were tested before and after performing. The VO 2 , Tre and skin temperature, and total body sweating, and local sweating during exercise were measured and compared between the groups. Results: The changes in VO 2 and Tre after the endurance exercise did not differ between the groups (DTre: AB group, 1.1°C 6 0.5°C; LLA group, 1.2°C 60.3 °C; P 5 0.65), whereas the amount of local sweating of the chest (group effect, P , 0.01 by two-way analysis of variance [group 3 time], the group effect size was medium, h 2 5 0.10) and dehydration rate (AB group, 1.5% 6 0.5%; LLA group, 2.1% 6 0.5%; P 5 0.03) were higher in the LLA than in the AB group. Conclusions: We compared the thermoregulatory responses of persons with LLA with those of AB individuals in hot and humid environments. Core body temperatures of persons with LLAs during endurance exercise were not different from those of AB men even in hot and humid environments. We found compensatory increases in the sweat rate of the chest and increased dehydration rate in persons with LLA. More sweat potentially means that athletes with LLA need to drink more fulids.

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Section: Methodsmentioning

confidence: 99%

Thermoregulatory responses in persons with lower-limb amputation during upper-limb endurance exercise in a hot and humid environment

Fukuhara

Mikami

Hasegawa

et al. 2021

Prosthetics &Amp; Orthotics International

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“…The intervention is in-centre, high-volume HDF which is usually delivered for around 4 hours three times a week aiming for a sessional 21+L of substitution uid per 1.73m 2 body surface area (30,31), adjusted pro rata for patients dialysing more than three times a week. This requires sterile water (bacterial limit <10 -6 CFU per mL; endotoxin limit <0.03 EU per mL).…”

Section: Intervention Description {11a}mentioning

confidence: 99%

The High-volume Haemodiafiltration vs High-flux Haemodialysis Registry Trial (H4RT): a multi-centre, unblinded, randomised, parallel-group, superiority study to compare the effectiveness and cost-effectiveness of high-volume haemodiafiltration and high-flux haemodialysis in people with kidney failure on maintenance dialysis using linkage to routine healthcare databases for outcomes.

Caskey

Procter

MacNeill

et al. 2022

Preprint

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Background More than a third of the 65,000 people living with kidney failure in the UK attend a dialysis unit 2–5 times a week to have their blood cleaned for 3–5 hours. In haemodialysis (HD) toxins are removed by diffusion, which can be enhanced using a high-flux dialyser. This can be augmented with convection, as occurs in haemodiafiltration (HDF) and improved outcomes have been reported in people who are able to achieve high volumes of convection. This study compares the clinical- and cost-effectiveness of high-volume HDF compared with high-flux HD in the treatment of kidney failure. Methods This is a UK-based, multi-centre, non-blinded randomised controlled trial. Adult patients already receiving HD or HDF will be randomised 1:1 to high-volume HDF (aiming for 21 + L of substitution fluid adjusted for body surface area) or high-flux HD. Exclusion criteria include lack of capacity to consent, life expectancy less than 3 months, on HD/HDF for less than 4 weeks, planned living kidney donor transplant or home dialysis scheduled within 3 months, prior intolerance of HDF, and not suitable for high-volume HDF for other clinical reasons. The primary outcome is a composite of non-cancer mortality or hospital admission with a cardiovascular event or infection during follow-up (minimum 32 months, maximum 91 months) determined from routine data. Secondary outcomes include all-cause mortality, cardiovascular and infection related morbidity and mortality, health-related quality of life, cost-effectiveness and environmental impact. Baseline data will be collected by research personnel on-site. Follow up data will be collected by linkage to routine healthcare databases – Hospital Episode Statistics, Civil Registration, Public Health England, and the UK Renal Registry (UKRR) in England, and equivalent databases in Scotland and Wales, as necessary – and centrally administered patient completed questionnaires. In addition, research personnel on-site will monitor for adverse events and collect data on adherence to the protocol (monthly during recruitment and quarterly during follow-up). Discussion This study will provide evidence of the effectiveness and cost effectiveness of HD as compared to HDF for adults with kidney failure in-centre HD or HDF. It will inform management for this patient group in the UK and internationally. Trial registration: ISRCTN10997319. Registered on 10th October 2017.

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“…12 To account for his limb loss when calculating BSA, the authors utilized the “rule of nines” of burn medicine. 13,14 From his preamputation body weight obtained from available records, 9% and 18% of his BSA were reduced to account for below-the-knee amputation of the right leg and above-the-knee amputation of the left leg, respectively. The dose of FOLFIRINOX was then further reduced by 20% due to toxicity concerns.…”

Section: Estimation Of Body Weight and Bsamentioning

confidence: 99%

Pharmacokinetic Considerations in Amputees

Elbarbry

Nguyen

Kawaguchi‐Suzuki

2020

Journal of Pharmacy Practice

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Purpose: The purpose of this article is to review the currently available assessment tools for measuring renal function, body weight, and body surface area in the amputee population. Methods: PubMed and Web of Science were searched using the following key terms: amputation, dose adjustment, and estimation of body weight. Articles published in languages other than English were excluded from the search. Results: Despite the increasing prevalence of amputations, there is little literature available that discusses its impact on the patient and how these physiological changes can affect pharmacokinetics. Very little information is available to guide dose adjustment in this patient population. This article discusses several factors to consider when determining optimum dosing regimens in patients with different levels of amputations. Conclusion: This article will evaluate the applicability of methods mentioned in existing literature for measuring changes in renal function, body weight, and body surface area in amputees.

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Two methods for estimating body surface area in adult amputees

Cited by 10 publications

References 0 publications

Thermoregulatory responses in persons with lower-limb amputation during upper-limb endurance exercise in a hot and humid environment

Thermoregulatory responses in persons with lower-limb amputation during upper-limb endurance exercise in a hot and humid environment

Pharmacokinetic Considerations in Amputees

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