A comparison of actual versus estimated weights among Filipino children using the original and updated Advanced Paediatric Life Support (APLS) Formulae, Mercy Method and Broselow Tape: A prospective study

@#<p style="text-align: justify;"><strong>Introduction.</strong> In resuscitating children, actual weight should be obtained before intervention. However, this is not always possible in the emergency setting. Identifying a simple, accurate, and precise method of weight estimation is essential in the delivery of optimal care for Filipino children seen at the emergency department.</p><p style="text-align: justify;"><strong>Objectives.</strong> To evaluate and compare the accuracy and precision of different weight estimation methods in Filipino children.</p><p style="text-align: justify;"><strong>Methods.</strong> A cross-sectional, single-center study was conducted among patients aged >28 days-12 years seen at the Philippine General Hospital Emergency Room. The traditional and updated Advanced Pediatric Life Support (APLS), Broselow tape, and Mercy Method were used for weight estimation. Bland Altman analysis was performed to see the mean difference and limits of agreement between actual and estimated weights of the children.</p><p style="text-align: justify;"><strong>Results.</strong> Broselow tape gave the closest average weight estimate, overestimating it by 0.7 kg, followed by Mercy method at 0.955 kg higher than actual. Traditional APLS yielded 1.565 kg and the Updated APLS 3.299 kg. Mercy Method had the narrowest limit of agreement.</p><p style="text-align: justify;"><strong>Conclusion.</strong> Among the four weight estimation methods, Broselow tape is the most accurate while the Mercy method is the most precise. Traditional APLS performed better than the updated APLS. Length-based methods and anthropometric surrogates proved to be more reliable than age-based formulae.</p>

Estimativa de peso corporal e estatura em idosos: concordância entre métodos / Estimated body weight and height in older adults: agreement between methods

OBJETIVO: Comparar os métodos de estimativa de peso corporal e altura em idosos e identificar o(s) melhor(es). MÉTODOS: Trata-se de um estudo do tipo descritivo e transversal realizado em uma clínica de saúde do município de Lagarto (SE). A população do estudo foram idosos de ambos os sexos com capacidade de deambulação. Aferiram-se peso corporal, altura, altura do joelho, circunferência da panturrilha, circunferência do braço, circunferência da cintura, meia envergadura do braço e prega cutânea subescapular, e foram avaliadas as equações de estimativa de altura e peso corporal. Em seguida, as equações foram comparadas aos valores de peso e altura aferidos, verificando-se se havia discordância entre essas variáveis. Utilizou-se o teste de correlação de Pearson, o teste t pareado e o teste de Bland-Altman. Para todos os testes, adotou-se como nível de significância estatística o valor de p ≤ 0,05. RESULTADOS: Participaram do estudo 63 pacientes, sendo a maioria do sexo feminino (74,6%), com média de idade de 68,1 ± 5,8 anos. Notou-se que a equação de Rabito et al., que utiliza a circunferência do braço, apresentou menor diferença de média. Em relação ao peso, a equação de Chumlea et al. apontou a menor diferença de média para o peso aferido. CONCLUSÃO: Recomendam-se as equações supracitadas para a obtenção da altura e do peso corporal em idosos, especialmente nessa população.

OBJECTIVE: To compare different equations to estimate body weight and height in older adults and determine which ones provide the most reliable estimates. METHODS: This descriptive, cross-sectional study was conducted at a health clinic in Lagarto, Sergipe, Brazil. The sample consisted of older men and women who were able to walk. We measured body weight, body height, knee height, calf circumference, arm circumference, waist circumference, half arm span, and subscapular skinfold thickness. Then, we used different equations to estimate weight and height in that sample. The results of the equations were compared with actual measures of weight and height to determine their level of agreement. Paired t-test and Bland-Altman test were used in the statistical analysis. The level of statistical significance was set at p ≤ 0.05. RESULTS: Sixty-three patients participated in the study. Most of them were women (74.6%), and mean age was 68.1 ± 5.8 years. Rabito et al.'s equation, which uses arm circumference to estimate height, showed a smaller mean difference from the actual measure. Regarding weight, Chumlea et al.'s equation showed a smaller mean difference. CONCLUSION: Those two equations are recommended to assess height and weight, especially in the older population

Development of a weight-estimation model to use in pregnant criollo-type mares / Modelo para estimativa de peso em éguas gestantes mestiças crioulas

ABSTRACT: The aims of this study were: 1) to compare the tape weight and associated weight-estimation formula to evaluate weight gain in pregnant mares, and 2) to develop a mathematical model to estimate the weight of pregnant mares using body measurements. Thirty-four criollo-type mares were evaluated every two weeks during the middle and late pregnancy. The mares were weighed on a livestock scale, and we estimated body weight using tape weights and an associated body-weight estimation formula. Also, heart-girth circumference (heartgirth) and abdominal circumference were measured; the latter at the 12th intercostal space (12th ICS) and 18th rib (18th Rib), to use in a mathematical model to estimate the weight of pregnant mares. Observations were divided into three periods of pregnancy: 5th to 7 h month, 7th to 9 h month, and 9th to 11th month. Mares in late pregnancy showed an increase in actual weight and an increase in 12th ICS and 18th Rib measurements. Tape weight and body-weight estimation formula underestimated the weight of pregnant mares. However, the regression model using heart-girth circumference, 12th ICS, and 18th Rib measurements showed high correlation (r2 = 0.87, P<0.001) with actual weight. Finally, the alternative methods usually used in horses are not accurate to estimate body weight in pregnant mares. In conclusion, the regression model Y=-540.143 + (heartgirth x 3.068) + (12th ICS x 1.278) + (18th Rib x 0.944) can be used to estimate body weight in pregnant mares from the 5th to 11th months of pregnancy.

RESUMO: Este estudo teve como objetivos: 1) comparar a utilização dos métodos alternativos fita de pesagem e peso metabólico em éguas gestantes e; 2) desenvolver um modelo matemático para estimar o peso de éguas gestantes, baseado em medidas corporais. Trinta e quatro éguas foram avaliadas quinzenalmente durante o terço médio e final da gestação. Foi realizada a pesagem em balança comercial; a mensuração com a fita de peso para equinos; o cálculo do peso metabólico; as medidas de perímetro torácico (Ptorac); a mensuração abdominal no décimo segundo espaço intercostal (12EI) e na décima oitava costela (18Cost). As observações foram divididas em três períodos gestacionais: Período de 5 a 7 meses, Período de 7 a 9 meses e Período de 9 a 11 meses. As éguas demonstraram incremento no peso na balança e na mensuração abdominal no 12EI e 18Cost no terço final da gestação. A utilização da fita de pesagem e o cálculo de peso metabólico subestimaram o peso na balança em éguas gestantes. O modelo de regressão utilizando o Ptorac, 12EI e 18Cost apresentou alta correção (r2=0,87; P<0,001) com o peso na balança. Observou-se que os métodos alternativos de pesagem, usualmente utilizados, não apresentaram a mesma eficiência em éguas prenhes. Pode-se concluir que o modelo de regressão Y=-540,143+(Ptorac X 3,068) + (12EI X 1,278) + (18Cost X 0,944) pode ser utilizado para mensurar o peso em éguas gestantes a partir do 5º mês de gestação.

Feasibility and Accuracy of Magnetic Resource Image with Three-dimensional Reconstruction and Volume Measurement in Estimation of Fetal Weight / 中国医学影像学杂志

Purpose Full-term fetal weight is closely related to the choice of delivery mode and perinatal mortality rate.Our aim is to explore the feasibility of magnetic resource image (MRI) with three-dimensional reconstruction and volume measurement in estimating fetal weight and its accuracy compared to ultrasound (US) examination.Materials and Methods Analyzed the MRI volume measurement of 61 fetuses delivered within 7 days after M RI and ultrasound examination in our hospital between November 2013 and March 2016 using MRI three-dimensional reconstruction.The fetal weight estimated by MRI was calculated by the equation developed by Baker et al and the US estimation of fetal weight was performed according to Haldlock et al,the MRI and US estimation of fetal weight were compared.Results 60 fetuses were included and qualified MRI three-dimensional reconstruction models,one was excluded because of frequent movement.The MRI estimation of fetal weight and the birth weight correlated significantly (r=0.927,P＜0.05).The MRI estimation of fetal weight had a lower percentage of random error than US (3.4％ vs 5.0％,P＞0.05),as well as mean absolute error [(172+ 114) g vs (227± 171) g,P＜0.05],but a higher percentage of relative error ≤ 10％ than US (95.0％ vs 78.3％,P＜0.05),with an underestimation in 90.0％ fetuses compared with birth-weight.Concision Full-term fetal weight estimation by using MRI with three-dimensional reconstruction and volume measurement is feasible and more accurate than ultrasound,but lower than the actual weight.This method can be applied in estimating fetal weight in the case of ultrasound examination limited.

The RAMA Ped Card: Does it work for actual weight estimation in child patients at the emergency department / 世界急诊医学杂志（英文）

BACKGROUND:In emergency conditions, the actual weight of infants and young children are essential for treatments. The RAMATHIBODI Pediatric Emergency Drug Card or RAMA Ped Card has also been developed to estimate actual weight of the subjects. This study aimed to validate the RAMA Ped Card in correctly identifying the actual weight of infants and young adults. METHODS:This study was a prospective study. We enrolled all consecutive patients under 15 years of age who visited the emergency department (ED). All eligible patients' actual weight and height were measured at the screening point of the ED. The weight of each patient was also measured using the unlabeled RAMA Ped Card. The Cohen's kappa values and agreement percentages were calculated. RESULTS:During the study period, there were 345 eligible patients. The RAMA Ped Card had a 61.16％ agreement with the actual weight with a kappa of 0.54 (P<0.01), while the agreement with the actual height had a kappa of 0.90 and 91.59％ agreement. Sub-group analysis found kappa scores with good range in two categories:in cases of accidents and in the infant group (kappa of 0.68 and 0.65, respectively). CONCLUSION:The RAMA Ped Card had a fair correlation with the actual weight in child patients presenting at the ED. Weight estimation in infant patients and children who presented with accidents were more accurate.

Eficacia de distintas fórmulas ecográficas en la estimación del peso fetal a término / Effectiveness of different echography formulas to estimate the term fetal weight

El peso para la edad gestacional es la variable que más se asocia estadísticamente con la morbi-mortalidad perinatal. OBJETIVO: Identificar la eficiencia de distintas fórmulas para la estimación del peso fetal en el embarazo a término. MÉTODOS: Se realizó un estudio prospectivo, descriptivo al azar de 88 gestantes entre 38 y 41,5 sem provenientes de la consulta de término del Hospital Ramón González Coro, de mayo a junio de 2007, a las que se les realizó biometrías según técnicas propuestas por Hadlock y Campbell, para estimación de peso fetal por ultrasonido empleando cuatro ecuaciones de regresión logarítmica, 7 días antes del nacimiento y se comparó con el peso al nacer. Se realizó análisis estadístico de frecuencia absoluta y relativa, media y desviación estśndar, comparación de medias e indicadores para evaluar eficacia de las fórmulas. RESULTADOS: La media de las gestantes era de 40,4 sem, el peso del recién nacido 3 540 g, el Índice de líquido amniótico de 12,2 y se realizó ecografía 5 días antes del nacimiento. Se demuestra que la fórmula más eficaz fue la de Campbell con una diferencia de 29,75 g con relación al peso del recién nacido, una sensibilidad del 91,3 por ciento una especificidad del 68,4 por ciento, valor predictivo positivo del 91 por ciento y valor predictivo negativo de 68,4 por ciento. CONCLUSIONES: La fórmula de Campbell fue la de mayor sensibilidad y valores predictivos positivo y negativo, pero resultó la de menor especificidad comparada con Hadlock. Se recomienda la estimación del peso fetal en la consulta de térrmino solo cuando los antecedentes, evolución y examen físico lo requieran

The weight for gestational age is the statistical variable more associated with perinatal mortality. OBJECTIVE: To identify the different formulas for fetal weight estimation in the term pregnancy. METHODS: A randomized, descriptive and prospective study was conducted in 88 pregnant between 38 and 45 weeks seen in the term consultation of Ramón González Coro Gynecology-Obstetrics Hospital from May to June, 2007 underwent biometry tests according to the proposed techniques by Hadlock and Campbell to estimate the fetal weight by ultrasound (US) using four logarithm regressive equations seven days before the birth comparing it with the weight birth A absolute and relative frequency analysis was made as well as mean and standard deviation (SD),mean comparisons and indicators to assess the formulae effectiveness. RESULTS: Pregnant mean was of 40,4 weeks, newborn weight was of 3 540 g, amniotic fluid rate was of 12,2 and a echography five days before birth. Campbell's formula was the more effectiveness with a difference of 29,75 g with relation to the newborn weight, a sensitivity of 91,3 percent, a specificity of 68.4 percent, a positive predictive value of 91,6 percent and a negative predictive value of 68,4 percent. CONCLUSIONS: The Campbell's formula has the great sensitivity as well as positive and negative predictive values but with the lowest specificity compared with that of Hadlock. It is recommended the fetal weight estimation only when backgrounds, course and physical examination considered it necessary