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Length‐based body weight estimation in paediatric patients: The impact of habitus—A clinical observational trial
Author(s) -
Schmidt A. R.,
Buehler P. K.,
Meyer J.,
Weiss M.,
Schmitz A.,
Both C. P.
Publication year - 2018
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13179
Subject(s) - medicine , observational study , habitus , clinical trial , estimation , body weight , randomized controlled trial , pediatrics , physical therapy , intensive care medicine , surgery , management , archaeology , ethnography , economics , history
Background Paediatric emergency tapes provide drug dosing based on the patient's estimated body weight. Unfortunately, published data revealed an unsatisfactory accuracy. A newly developed digital algorithm for weight estimation (CLAWAR) allowing a three‐staged habitus adaptation (normal, obese, or cachectic; CLAWAR‐3) demonstrated a higher accuracy for weight estimation compared to paediatric emergency tapes. However, the incidence of incorrectly evaluated habitus was 27%. A five‐staged habitus adaptation with figural images was suggested by Wells et al to improve habitus and weight estimation. Therefore, CLAWAR was modified with five habitus stages including figural images (CLAWAR‐5). We hypothized CLAWAR‐5 improves the accuracy of weight estimation. Methods After obtaining informed written parental consent patients were included in this single centre, prospective clinical observation trial. Body weight estimations by CLAWAR‐3 and CLAWAR‐5 within ±10% of the actual body weight were compared. Furthermore, the incidence of correct evaluated habitus was calculated. McNemar Tests were used for statistical analysis. Results presented as median (interquartiles), P < .003 considered significant. Results In total, 312 patients aged 3.3 years (0.7‐6.6), with a body length of 95.9 cm (70.0‐121.2), weighing 14.8 kg (8.1‐22.5), were included. Both CLAWAR‐3 and CLAWAR‐5 showed equivalent accuracy for weight estimation within the ±10% interval (62.2% vs 60.6%, P = .609). Despite adding figural images, the incidence of correct evaluated habitus with CLAWAR‐5 (46.8%) was worse than with CLAWAR‐3 (66.7%). Conclusion The five‐staged habitus‐adapted method could not improve the accuracy of weight estimation. Furthermore, the error rate of habitus classification was not reduced by the implementation of figural images.