Dataset Information

Weight estimation in resuscitation: is the current formula still valid?

ABSTRACT:

Objectives

To gather data on the ages and weights of paediatric patients between 1 and 10 years of age, and to compare these data with the current weight estimation formula weight(kg) = 2(age+4). If a significant difference was found, the data would be used to derive a more accurate formula.

Design

Retrospective study using data collected from paediatric attendances at an emergency department (ED).

Setting

A large ED in a major UK city, treating both children and adults.

Patients

17 244 children aged 1-10 years, attending the ED between June and December 2005.

Main outcome measures

Weight difference between the measured weight and the expected weight, the latter given by weight = 2(age+4).

Results

The weights of seriously ill children were recorded in only 41.5% of cases, necessitating a weight estimate in the remainder. The formula weight = 2(age+4) underestimated children's weights by a mean of 18.8% (95% confidence interval (95% CI) 18.42% to 19.18%). Using linear regression and analysis of each individual age group, ten new formulas were tested. Of these formulas, weight(kg) = 3(age)+7 proved the most accurate with a mean underestimate of just 2.48% (95% CI 2.17% to 2.79%).

Conclusions

Weight estimation remains of paramount importance in paediatric resuscitation. This study shows that the current estimation formula provides a significant underestimate of children's weights. When used to calculate drug and fluid dosages, this may lead to the under-resuscitation of a critically ill child. The formula weight(kg) = 3(age)+7 provided a safe and more accurate estimate of the weight of today's child.

SUBMITTER: Luscombe M

PROVIDER: S-EPMC2083737 | biostudies-literature | 2007 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Weight estimation in resuscitation: is the current formula still valid?

Luscombe Mark M Owens Ben B

Archives of disease in childhood 20070109 5

<h4>Objectives</h4>To gather data on the ages and weights of paediatric patients between 1 and 10 years of age, and to compare these data with the current weight estimation formula weight(kg) = 2(age+4). If a significant difference was found, the data would be used to derive a more accurate formula.<h4>Design</h4>Retrospective study using data collected from paediatric attendances at an emergency department (ED).<h4>Setting</h4>A large ED in a major UK city, treating both children and adults.<h4 ...[more]

PMID: 17213259

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Project description:The administration of intravenous fluid to critically ill patients is one of the most common, but also one of the most fiercely debated, interventions in intensive care medicine. Even though many thousands of patients have been enrolled in large trials of alternative fluid strategies, consensus remains elusive and practice is widely variable. Critically ill patients are significantly heterogeneous, making a one size fits all approach unlikely to be successful.New data from basic, animal, and clinical research suggest that fluid resuscitation could be associated with significant harm. There are several important limitations and concerns regarding fluid bolus therapy as it is currently being used in clinical practice. These include, but are not limited to: the lack of an agreed definition; limited and short-lived physiological effects; no evidence of an effect on relevant patient outcomes; and the potential to contribute to fluid overload, specifically when fluid responsiveness is not assessed and when targets and safety limits are not used.Fluid administration in critically ill patients requires clinicians to integrate abnormal physiological parameters into a clinical decision-making model that also incorporates the likely diagnosis and the likely risk or benefit in the specific patient's context. Personalised fluid resuscitation requires careful attention to the mnemonic CIT TAIT: context, indication, targets, timing, amount of fluid, infusion strategy, and type of fluid.The research agenda should focus on experimental and clinical studies to: improve our understanding of the physiological effects of fluid infusion, e.g. on the glycocalyx; evaluate new types of fluids; evaluate novel fluid minimisation protocols; study the effects of a no-fluid strategy for selected patients and scenarios; and compare fluid therapy with other interventions. The adaptive platform trial design may provide us with the tools to evaluate these types of interventions in the intrinsically heterogeneous intensive care unit population, accounting for the explicit assumption that treatment effects may be heterogeneous.

Dataset Information

Weight estimation in resuscitation: is the current formula still valid?

Objectives

Design

Setting

Patients

Main outcome measures

Results

Conclusions

Publications

Weight estimation in resuscitation: is the current formula still valid?

Similar Datasets

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