![]() ![]() The BMI method has the advantage of being able to account for normal patterns of body composition changes, but it requires multiple steps of both graphing on a BMI growth chart and calculating the value using an equation.Initiation and Titration of NIV/BiPAP Settings The ADA method can be graphed quicker than the McLaren or Moore methods, but it does not account for patient's height. The Moore method offers the advantage of only needing a growth chart, but approximation is required when a patient's height does not fall exactly on one of the percentile lines on the growth chart. The Traub and simplified Traub equations do not account for the patient's age. The Devine method does not require any graphing, but it is designed for adults and many pediatric patients are not more than 60 inches tall. In addition, some children may be too tall to be estimated by this method. The McLaren method offers the advantage of only needing a growth chart, but it does not account for patient's age in the final IBW determination. The various methods also have different pros and cons to their use. For all methods requiring growth charts, these were obtained from the Centers for Disease Control and Prevention website. 7ĭata analysis was separated into 2 cohorts because height is typically measured in the supine position when patients are 60 inches tall. 6 Although many different IBW calculation methods exist, there is no consensus on the most accurate method for pediatric patients. 4, 5 Furthermore, IBW is important for the classification of nutritional status. Incorrect dosing is the most commonly reported medication error in children and can lead to lack of efficacy if subtherapeutic or toxicity if supratherapeutic. 3 The Pediatric Pharmacy Advocacy Group recommends that clinicians should consider pharmacokinetic analysis for adjusting medications whenever possible in children with obesity to ensure the most effective and safe regimen. 1 Dosing considerations regarding IBW may be especially true for patients with obesity, and the obesity rate for patients ages 2 to 19 years from 2011 to 2014 was 17%. 2 IBW is defined as being a reflection of lean body mass. 1 It can also lead to discrepancies in the care of serious conditions such as acute respiratory distress syndrome. 2 If IBW is calculated inaccurately, it can lead to under or over dosing of medications, causing reduced efficacy or increased toxicity. 1 It is also crucial in other scenarios, such as tidal volumes prescribed in mechanically ventilated patients. ![]() For certain methods, these differences become pronounced at high and low height percentiles and in older age groups.Īccurate determination of ideal body weight (IBW) in pediatric patients is important for the proper dosing of many medications, such as acyclovir, digoxin, and morphine. For cohort 2 (n = 1095), the BMI method was not statistically different from the McLaren method with a mean difference of 0.17 kg (95% CI: −0.07 to 0.40, p = 0.17).ĬONCLUSIONS In both cohorts, the majority of methods used to calculate IBW in pediatric patients leads to statistically different results when compared with the McLaren method. RESULTS For cohort 1 (n = 347), the Moore method was not statistically different from the McLaren method with a mean difference of −0.07 kg (95% CI: −0.14 to 0.01, p = 0.07). The McLaren method was used as the reference to compare with 6 other methods: Moore method, Devine method, American Dietetic Association (ADA) method, body mass index (BMI) method, Traub equation, and simplified Traub equation. Subjects were divided into 2 cohorts: cohort 1 was aged 12 months and 0 day to 35 months and 30 days, and cohort 2 was aged 36 months and 0 day to 17 years and 364 days. All subjects were pediatric inpatients at a 536-bed community teaching hospital between January 1, 2016, and June 30, 2017. METHODS This was a retrospective observational study. The purpose of this study is to evaluate and compare 7 different methods used to calculate IBW in the pediatric population. There is no consensus on the best method to calculate IBW. OBJECTIVES Accurate determination of ideal body weight (IBW) in pediatric patients is important for the proper dosing of many medications and the classification of nutritional status. ![]()
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