Accuracy of weight and height estimation in an intensive care unit: Implications for clinical practice and research
ABSTRACT Numerous calculations routinely used in the intensive care require the knowledge of patients' weight and height, although these measurements are not always made. Estimates by doctors or nurses are often substituted. This study sought to ascertain the accuracy of estimates of weight and height of patients made by intensive care unit (ICU) staff.
: Prospective clinical study.
Sixteen-bed mixed medical and surgical ICU in a university teaching hospital.
Fourteen patients had their height and weight estimated by 20 members of the medical and nursing staff.
After all estimates had been recorded, measurements of weight and height were obtained. Weight was measured by means of a patient hoist with a calibrated weighing facility and height using a steel tape measure.
Estimation of weight was poor, with 47% of estimates at least 10% different and 19% of estimates at least 20% different from the measured values. The majority of height estimates were within 10% of the measured values.
Individual estimates of weight and height are frequently inaccurate. These errors of estimation could compromise application of effective therapies, as well as contribute to a reduction in design sensitivity of clinical trials.
- SourceAvailable from: Michael E Dolch
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- "accuracy of estimation is poor, and BMI derived from these estimates might therefore be severely inaccurate . "
ABSTRACT: Obesity is a worldwide pandemic, and obese patients face an increased risk of developing acute respiratory distress syndrome (ARDS). Prone positioning (PP) is a frequently used intervention in the treatment of ARDS. There are no data describing the impact of PP on morbidity and mortality in abdominally obese patients. We report our observations in abdominally obese ARDS patients treated with PP. Patients with ARDS (n = 82) were retrospectively divided into 2 groups characterized by presence (n = 41) or absence (n = 41) of abdominal obesity as defined by a sagittal abdominal diameter of 26 cm or more. There was no difference in cumulative time abdominally obese patients were placed in prone position from admission to day 7 (41.0 hours [interquartile range, 50.5 hours] vs 39.5 hours [interquartile range, 61.5 hours]; P = .65) or in overall intensive care unit mortality (34% vs 34%; P = 1). However, abdominally obese patients developed renal failure (83% vs 35%; P < .001) and hypoxic hepatitis (22% vs 2%; P = .015) more frequently. A significant interaction effect between abdominal obesity and prone position with respect to mortality risk (likelihood ratio, P = .0004) was seen if abdominally obese patients were treated with prolonged cumulative PP. A cautious approach to PP should be considered in abdominally obese patients.Journal of critical care 02/2014; 29(4). DOI:10.1016/j.jcrc.2014.02.010 · 2.00 Impact Factor
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- "This is especially true outside of the surgical ICU (i.e., emergency department, postanesthesia recovery room or medical ICU) because surgical ICUs are more likely to have height and weight measurements due to the operative record . In addition, visual estimation of patient height and weight is known to be inaccurate [109–111], and shorter patients, often women, tend to be more severely affected [54, 112]. The ability to rapidly calculate PBW at the bedside is important. "
ABSTRACT: Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges.Critical care research and practice 03/2012; 2012(5):416862. DOI:10.1155/2012/416862
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- "The estimation of simple morpho-functional variables, such as reaching capability, seems to be more accurate than the estimation of functional active variables that involve actions of higher complexity, such as a reach-and-jump task (Pepping & Li, 2005). The estimation of morphological variables has been addressed in medical settings (Bloomfield et al., 2006; Determann et al., 2007), but not in the scope of affordances perception. The relationship between the estimation of simple morphological variables (e.g., height) and estimations of morphofunctional variables (e.g., reachability) has not been previously investigated. "
ABSTRACT: This study investigated the influence of some characteristics of the task, the model, and the observer, in the estimation errors of adults while judging children's affordances. One hundred and eighteen adults, divided in 4 height groups, estimated height and vertical reaching capability of 3 girls (3.55-, 4.74- and 7.06-years old), in the presence and in the absence of the model. Constant errors (CE) (estimation-real value), absolute percent errors (APE) (/1--estimation/real value/ x 100), and error tendency (underestimations, right judgments, or overestimations) were calculated. A model and a condition effect were verified on APE. APE for the younger model were greater than for the other models (p<0.001), and APE in the absence of the model were greater than in her presence (p<0.05). Generally, adults underestimated height (51.8% of underestimations vs. 32.3% of overestimations) and overestimated reachability (51.3% of overestimations vs. 37.7% of underestimations). The overestimation of reachability was more notorious for the younger model, which might reflect adults' difficulty to consider the specificity of younger children's body proportions. Actually, the overestimation bias may suggest that adults perceive young children as on the basis of adult's geometrical proportions.Acta psychologica 09/2010; 135(1):24-9. DOI:10.1016/j.actpsy.2010.04.008 · 2.19 Impact Factor