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Williamson H, Walsh C, Nel M, van den Berg L. Predictive value of different body segments to estimate height in a South African adult hospital population. Clin Nutr ESPEN 2022; 47:177-182. [DOI: 10.1016/j.clnesp.2021.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/20/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
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Valls-Matarín J, Del Cotillo-Fuente M, Miranda-Ramírez M, Parera-Pous AM. Laser meter, an alternative to determine the height in critical patients. Concordance study. Med Intensiva 2021; 45:e62-e64. [PMID: 34776406 DOI: 10.1016/j.medine.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/07/2020] [Indexed: 10/19/2022]
Affiliation(s)
- J Valls-Matarín
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, Spain.
| | - M Del Cotillo-Fuente
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
| | - M Miranda-Ramírez
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
| | - A M Parera-Pous
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, Spain
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Park JW, Kim M, Baek SH, Sung JH, Yu JG, Kim BJ. Body Fat Percentage and Availability of Oral Food Intake: Prognostic Factors and Implications for Nutrition in Amyotrophic Lateral Sclerosis. Nutrients 2021; 13:nu13113704. [PMID: 34835960 PMCID: PMC8622757 DOI: 10.3390/nu13113704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 01/01/2023] Open
Abstract
Adequate nutritional support and high body mass index (BMI) are good prognostic factors for disease progression and survival in amyotrophic lateral sclerosis (ALS). However, whether the composition of body weight, such as body fat percentage, has an independent effect on ALS prognosis remains unclear. The clinical data of 53 ALS patients were collected by medical record review. The data included: disease onset, sex, age, time of diagnosis, survival duration, presence of percutaneous endoscopic gastrostomy (PEG), nasogastric tube, tracheostomy, and availability of oral intake throughout the course of the disease, and interval measurement values of body mass by bioelectrical impedance analysis (BIA). The interval change (∆) of the BIA parameters was calculated by subtracting the follow-up values from the baseline values. Change in body fat percentage/interval between BIA measurements (months) (hazard ratio [HR] = 0.374, p = 0.0247), and availability of oral food intake (HR = 0.167, p = 0.02), were statistically significant for survival duration in multivariate hazard proportional regression analysis. Survival analysis and Kaplan–Meier curves showed similar results. Higher average monthly change in body fat percentage and availability of oral food intake are prognostic factors in ALS survival.
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Affiliation(s)
- Jin-Woo Park
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
| | | | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
| | - Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
| | - Jae-Guk Yu
- Rodem Hospital, Incheon 22142, Korea;
- Correspondence: (J.-G.Y.); (B.-J.K.); Tel.: +82-2-2286-8852 (B.-J.K.)
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
- BK21 FOUR Program in Learning Health Systems, Korea University, Seoul 02841, Korea
- Correspondence: (J.-G.Y.); (B.-J.K.); Tel.: +82-2-2286-8852 (B.-J.K.)
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Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One 2021; 16:e0253933. [PMID: 34260619 PMCID: PMC8279424 DOI: 10.1371/journal.pone.0253933] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022] Open
Abstract
Background Studies in patients receiving invasive ventilation show important differences in use of low tidal volume (VT) ventilation (LTVV) between females and males. The aims of this study were to describe temporal changes in VT and to determine what factors drive the sex difference in use of LTVV. Methods and findings This is a posthoc analysis of 2 large longitudinal projects in 59 ICUs in the United States, the ‘Medical information Mart for Intensive Care III’ (MIMIC III) and the ‘eICU Collaborative Research DataBase’. The proportion of patients under LTVV (median VT < 8 ml/kg PBW), was the primary outcome. Mediation analysis, a method to dissect total effect into direct and indirect effects, was used to understand which factors drive the sex difference. We included 3614 (44%) females and 4593 (56%) males. Median VT declined over the years, but with a persistent difference between females (from median 10.2 (9.1 to 11.4) to 8.2 (7.5 to 9.1) ml/kg PBW) vs. males (from median 9.2 [IQR 8.2 to 10.1] to 7.3 [IQR 6.6 to 8.0] ml/kg PBW) (P < .001). In females versus males, use of LTVV increased from 5 to 50% versus from 12 to 78% (difference, –27% [–29% to –25%]; P < .001). The sex difference was mainly driven by patients’ body height and actual body weight (adjusted average causal mediation effect, –30% [–33% to –27%]; P < .001, and 4 [3% to 4%]; P < .001). Conclusions While LTVV is increasingly used in females and males, females continue to receive LTVV less often than males. The sex difference is mainly driven by patients’ body height and actual body weight, and not necessarily by sex. Use of LTVV in females could improve by paying more attention to a correct calculation of VT, i.e., using the correct body height.
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Affiliation(s)
- Pien Swart
- Department of Intensive Care, Amsterdam UMC, Amsterdam, The Netherlands
- * E-mail:
| | - Rodrigo Octavio Deliberato
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Big Data Analytics Group, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Alistair E. W. Johnson
- Laboratory for Computational Physiology, Institute for Medical Engineering & Science, MIT, Cambridge, MA, United States of America
| | - Tom J. Pollard
- Laboratory for Computational Physiology, Institute for Medical Engineering & Science, MIT, Cambridge, MA, United States of America
| | - Lucas Bulgarelli
- Laboratory for Computational Physiology, Institute for Medical Engineering & Science, MIT, Cambridge, MA, United States of America
| | - Paolo Pelosi
- IRCCS San Martino Policlinico Hospital, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Marcelo Gama de Abreu
- Pulmonary Engineering Group, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
- Outcomes Research Consortium, Cleveland, OH, United States of America
| | - Marcus J. Schultz
- Department of Intensive Care, Amsterdam UMC, Amsterdam, The Netherlands
- Laboratory of Experimental Intensive Care and Anaesthesia (L·E·I·C·A), Amsterdam UMC, Amsterdam, The Netherlands
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ary Serpa Neto
- Department of Intensive Care, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Pulmonary Division, Cardio–Pulmonary Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
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Valls-Matarín J, Del Cotillo-Fuente M, Miranda-Ramírez M, Parera-Pous AM. Laser meter, an alternative to determine the height in critical patients. Concordance study. Med Intensiva 2020; 45:S0210-5691(20)30331-4. [PMID: 33309462 DOI: 10.1016/j.medin.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/24/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- J Valls-Matarín
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España.
| | - M Del Cotillo-Fuente
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España
| | - M Miranda-Ramírez
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España
| | - A M Parera-Pous
- Unidad de Críticos, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España
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Singh K, Gocool N. A Comparison of Three Methods of Height Estimation and Their Impact on Low Tidal Volume Ventilation in a Mixed Ethnicity Intensive Care Unit: A Real-World Experience. Cureus 2020; 12:e9221. [PMID: 32821572 PMCID: PMC7430537 DOI: 10.7759/cureus.9221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Height measurement is crucial for calculating predicted body weight (PBW) and establishing low tidal volume ventilation (LTVV). However, standing height is usually unavailable in critically ill patients and supine height may be difficult to obtain. Objective We investigated whether there were any significant differences in tidal volumes (VT) obtained using PBW derived from supine, forearm, and lower leg lengths in an intensive care unit (ICU) setting. Methods Supine, forearm and lower leg lengths were measured in 100 mechanically ventilated patients. Limb lengths were converted to height and PBW calculated using published formulae. The 6 mL/kg VT for the supine (sVT), forearm (fVT), and lower leg (lVT) methods were compared to each other and to visually estimated VT (estVT). Results Forearm length produced the greatest height estimate, leading to a significantly greater tidal volume fVT (437.6 ± 62.1 mL) compared with sVT (385.5 ± 63.8 mL) and lVT (369.1 ± 66.4 mL), (p < .001). There was no significant difference between lVT and sVT, (p = .169). On Bland Altman analysis, the lowest bias was found between lVT and sVT (−16.4 ± 36.0 mL, 95% limits of agreement (LOA) [−86.9, 54.1]), whereas fVT had a bias of 52.1 ± 41.5 mL, 95% LOA [−29.1, 133.4] compared to sVT. The fVT was significantly greater than sVT and lVT in all sexes and ethnic groups (p < .05). Conclusion Lower leg length may be a suitable alternative to supine height to facilitate the application of LTVV in an ICU setting.
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Oliveira PM, Moreira APB, Garios RS, Elias MAR. Comparação dos métodos de estimativa de peso e altura em pacientes hospitalizados. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2017.v43.2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
O objetivo deste estudo foi comparar o peso e altura aferidos com métodos de estimativa correspondentes em pacientes internados em um hospital da cidade de Juiz de Fora. Estudo transversal realizado no período de maio a dezembro de 2016 com a coleta dos seguintes dados: gênero, idade, raça, motivo da internação, peso, altura, altura do joelho, circunferência do braço, abdominal e da panturrilha, comprimento do braço e da ulna, semi-envergadura do braço e dobra cutânea subescapular. Foi empregado teste t pareado para comparar os valores de peso e altura aferidos foram com aqueles obtidos a partir de fórmulas de estimativa, considerando nível de significância estatística o valor de p < 0,05. Foram avaliados 90 pacientes, sendo 53,3% mulheres, 67,7% adultos e 68,9% eutróficos. Para a estimativa de peso corporal, as fórmulas de CHUMLEA et al. (1985) e (1994), RABITO et al. (2008) e MARTÍN et al. (2013) não se diferenciaram da medida de peso aferido (p > 0,05). Para a estimativa de altura, as fórmulas que não se diferenciaram foram as de CHUMLEA et al. (1985), CHUMLEA et al. (1994) e SILVEIRA et al. (1994) (p > 0,05). Concluiu-se que as equações de estimativa de peso e altura que utilizaram medidas de circunferências e altura do joelho em suas fórmulas se demonstraram adequadas para a estimativa de peso e altura em adultos e idosos hospitalizados. A escolha do método deverá ser baseada conforme disponibilidade de equipamentos e avaliadores treinados para realização das medidas.
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McFall A, Peake SL, Williams PJ. Weight and height documentation: Does ICU measure up? Aust Crit Care 2018; 32:314-318. [PMID: 30005937 DOI: 10.1016/j.aucc.2018.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reliable assessment and documentation of weight and height are essential for the accurate delivery of many critical care interventions. METHODS We conducted a 3-month retrospective, cross-sectional, single-centre audit to determine the prevalence of weight and height documentation in the clinical records of patients admitted to the intensive care unit (ICU) for the period from 3 months prior to hospital admission up to hospital discharge. RESULTS One hundred forty-one index ICU admissions were identified from October-December 2015 with 138 medical records available for analysis. Median (interquartile range) age was 64.5 (50.8-75.3) years, the majority were male (60.9%, 84/138), and the ICU admission Acute Physiology and Chronic Health Evaluation II score was 19.0 (14.0-25.0). Overall, weight and height were recorded in 90 (65.2%) and 63 (45.6%) patients, respectively. For elective postoperative admissions (n = 20), weight and height were recorded in 20 (100%) and 19 (95%) patients. For emergency medical and surgical admissions, 70 (59.3%) and 44 (37.2%) patients had weight and height recorded in both the 3-month period prior to hospital admission and the in-hospital period. A moderate, positive correlation was shown, r = 0.55, P < 0.001, with a longer hospital length of stay being associated with a greater number of weight and height records for each patient. In the emergency patient cohort, 81.7% (n = 215/263) of weight- and/or height-based interventions occurred before or during the ICU admission, of which 69.9% (n = 184/263) required consideration of ideal body weight. CONCLUSION Measurement and medical record documentation of weight and height is infrequently performed in ICU patients. Given the clinical requirement for accurate measurement and documentation, further research to understand the barriers to perform and document this important process of care is necessary.
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Affiliation(s)
- Alan McFall
- The Queen Elizabeth Hospital, Department of Intensive Care Medicine, 28 Woodville Road, Woodville South, 5011, South Australia, Australia.
| | - Sandra L Peake
- The Queen Elizabeth Hospital, Department of Intensive Care Medicine, 28 Woodville Road, Woodville South, 5011, South Australia, Australia; School of Medicine, University of Adelaide, North Terrace, Adelaide, 5000, South Australia, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, Victoria, Australia.
| | - Patrica J Williams
- The Queen Elizabeth Hospital, Department of Intensive Care Medicine, 28 Woodville Road, Woodville South, 5011, South Australia, Australia; School of Medicine, University of Adelaide, North Terrace, Adelaide, 5000, South Australia, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, Victoria, Australia.
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Sasko B, Thiem U, Christ M, Trappe HJ, Ritter O, Pagonas N. Size matters: An observational study investigating estimated height as a reference size for calculating tidal volumes if low tidal volume ventilation is required. PLoS One 2018; 13:e0199917. [PMID: 29958278 PMCID: PMC6025863 DOI: 10.1371/journal.pone.0199917] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/15/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose Acute lung injury is a life threatening condition often requiring mechanical ventilation. Lung-protective ventilation with tidal volumes of 6 mL/kg predicted body weight (PBW, calculated on the basis of a patient’s sex and height), is part of current recommended ventilation strategy. Hence, an exact height is necessary to provide optimal mechanical ventilation. However, it is a common practice to visually estimate the body height of mechanically ventilated patients and use these estimates as a reference size for ventilator settings. We aimed to determine if the common practice of estimating visual height to define tidal volume reduces the possibility of receiving lung-protective ventilation. Methods In this prospective observational study, 28 mechanically ventilated patients had their heights visually estimated by 20 nurses and 20 physicians. All medical professionals calculated the PBW and a corresponding tidal volume with 6 ml/kg/PBW on the basis of their visual estimation. The patients’ true heights were measured and the true PBW with a corresponding tidal volume was calculated. Finally, estimates and measurements were compared. Results 1033 estimations were undertaken by 153 medical professionals. The majority of the estimates were imprecise and resulting data comprised taller body heights, higher PBW and higher tidal volumes (all p≤0.01). When estimates of patients´ heights are used as a reference for tidal-volume definition, patients are exposed to mean tidal volumes of 6.5 ± 0.4 ml/kg/PBW. 526 estimation-based tidal volumes (51.1%) did not provide lung-protective ventilation. Shorter subjects (<175cm) were a specific risk group with an increased risk of not receiving lung protective ventilation (OR 6.6; 95%CI 1.2–35.4; p = 0.02), while taller subjects had a smaller risk of being exposed to inadequately high tidal volumes (OR 0.15; 95%CI 0.02–0.8; p = 0.02). Furthermore, we found an increased risk of overestimating if the assessor was a female (OR 1.74; 95%CI 1.14–2.65; p = 0.01). Conclusion The common practice of visually estimating body height and using these estimates for ventilator settings is imprecise and potentially harmful because it reduces the chance of receiving lung-protective ventilation. Avoiding this practice increases the patient safety. Instead, height should be measured as a standard procedure.
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Affiliation(s)
- Benjamin Sasko
- Department of Cardiology, Brandenburg Medical School, University Hospital Brandenburg, Germany
- Department of Cardiology, Marienhospital Herne, Ruhr-University Bochum, Herne, North Rhine-Westphalia, Germany
- * E-mail:
| | - Ulrich Thiem
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University Bochum, Bochum, North Rhine-Westphalia, Germany
| | - Martin Christ
- Department of Cardiology, Marienhospital Herne, Ruhr-University Bochum, Herne, North Rhine-Westphalia, Germany
| | - Hans-Joachim Trappe
- Department of Cardiology, Marienhospital Herne, Ruhr-University Bochum, Herne, North Rhine-Westphalia, Germany
| | - Oliver Ritter
- Department of Cardiology, Brandenburg Medical School, University Hospital Brandenburg, Germany
| | - Nikolaos Pagonas
- Department of Cardiology, Brandenburg Medical School, University Hospital Brandenburg, Germany
- Department of Nephrology, Marienhospital Herne, Ruhr-University Bochum, Herne, North Rhine-Westphalia, Germany
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Grau Carmona T. How much weight today doctor? Overconfidence or zeal excess. Med Intensiva 2018; 42:327-328. [PMID: 29398168 DOI: 10.1016/j.medin.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 10/28/2022]
Affiliation(s)
- T Grau Carmona
- Servicio de Medicina Intensiva, Hospital Universitario Doce de Octubre, Madrid, España.
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Rivers J, Brown J. Inaccuracies in calculating predicted body weight and its impact on safe ventilator settings ( Journal of the Intensive Care Society 2016; 17: 191–195). J Intensive Care Soc 2017; 18:256. [DOI: 10.1177/1751143717690179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jon Rivers
- Department of Intensive Care, Southmead Hospital, Bristol, UK
| | - Jules Brown
- Department of Intensive Care, Southmead Hospital, Bristol, UK
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12
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Martin DC, Richards GN. Predicted body weight relationships for protective ventilation - unisex proposals from pre-term through to adult. BMC Pulm Med 2017; 17:85. [PMID: 28535820 PMCID: PMC5442651 DOI: 10.1186/s12890-017-0427-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The lung-protective ventilation bundle has been shown to reduce mortality in adult acute respiratory distress syndrome (ARDS). This concept has expanded to other areas of acute adult ventilation and is recommended for pediatric ventilation. A component of lung-protective ventilation relies on a prediction of lean body weight from height. The predicted body weight (PBW) relationship employed in the ARDS Network trial is considered valid only for adults, with a dedicated formula required for each sex. No agreed PBW formula applies to smaller body sizes. This analysis investigated whether it might be practical to derive a unisex PBW formula spanning all body sizes, while retaining relevance to established adult protective ventilation practice. METHODS Historic population-based growth charts were adopted as a reference for lean body weight, from pre-term infant through to adult median weight. The traditional ARDSNet PBW formulae acted as the reference for prevailing protective ventilation practice. Error limits for derived PBW models were relative to these references. RESULTS The ARDSNet PBW formulae typically predict weights heavier than the population median, therefore no single relationship could satisfy both references. Four alternate piecewise-linear lean body-weight predictive formulae were presented for consideration, each with different balance between the objectives. CONCLUSIONS The 'PBWuf + MBW' model is proposed as an appropriate compromise between prevailing practice and simplification, while also better representing lean adult body-weight. This model applies the ARDSNet 'female' formula to both adult sexes, while providing a tight fit to median body weight at smaller statures down to pre-term. The 'PBWmf + MBW' model retains consistency with current practice over the adult range, while adding prediction for small statures.
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Affiliation(s)
- Dion C Martin
- ResMed Science Center, ResMed Ltd, 1 Elizabeth Macarthur Drive, Bella Vista, 2153, Sydney, Australia.
| | - Glenn N Richards
- ResMed Science Center, ResMed Ltd, 1 Elizabeth Macarthur Drive, Bella Vista, 2153, Sydney, Australia
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Rivers J, Brown J, Dolphin K, Squire Y. A calibrated measuring tape accurately predicts tidal volumes from ulna length. J Intensive Care Soc 2015; 16:302-305. [PMID: 28979435 DOI: 10.1177/1751143715583861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Low tidal volume ventilation improves outcomes in acute respiratory distress syndrome. Calculation of this volume requires knowledge of a patient's gender, and height, which may not be available in emergency admissions, and the subsequent application of a nomogram. The objective of this study was to test the accuracy of a calibrated measuring tape that reads in mL of tidal volume when the ulna is measured. METHODS The measuring tape was used to obtain an estimate of a subject's tidal volume from their ulna length, and standing height was then measured (reference method). RESULT A total of 100 healthy volunteers were included. Mean tidal volume was 450 mL for males and 372 mL for females when calculated from the height. Comparing tidal volumes from the tape with those from the reference method, Bland Altman analysis showed a bias of -10 mL (limits of agreement (2SD) -74 mL to 54 mL) for males and a bias of -36 mL (limits of agreement (2SD) -88 mL to 16 mL) for females. Predicted mean tidal volumes were 5.7 mL/kg (95% CI: 5.1-6.3 mL/kg) for males and 5.8 mL/kg (95% CI: 5.3-6.2 mL/kg) for females. CONCLUSIONS Usage of a calibrated measuring tape produced accurate estimates of tidal volumes required for lung protective ventilation in healthy volunteers.
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Affiliation(s)
- Jon Rivers
- Department of Anaesthetics, Southmead Hospital, Bristol, UK
| | - Jules Brown
- Department of Anaesthetics, Southmead Hospital, Bristol, UK
| | - Kirsty Dolphin
- Department of Anaesthetics, Southmead Hospital, Bristol, UK
| | - Yolande Squire
- Department of Anaesthetics, Southmead Hospital, Bristol, UK
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