Sinha Madhumita, Lezine Myra Wong, Frechette Alan, Foster Kevin N
Department of Pediatrics, Arizona Children's Center at Maricopa Medical Center, Phoenix, AZ 85008, USA.
Pediatr Emerg Care. 2012 Jun;28(6):544-7. doi: 10.1097/PEC.0b013e318258ac2e.
Obtaining an accurate weight is crucial during pediatric trauma/medical resuscitation. Currently, length-based weight estimations are used. Study objective was to assess feasibility of obtaining actual weights of children during trauma resuscitation and study its concordance with length-based estimated weight using the Broselow Pediatric Emergency Tape.
Pediatric trauma patients 0 to 14 years old presenting to a tertiary care pediatric trauma center between November 2008 and October 2009 were enrolled prospectively. Length-based weight estimation was done on patient arrival using the Broselow tape; in addition, an actual patient weight was recorded using the trauma stretcher integrated weighing scale.
Two hundred thirty-one patients were eligible and enrolled. Weights were recorded in 145 children (63.2%). In 27 patients (18.6%) whose body length exceeded Broselow tape range, weight was measured using stretcher scale only. The remaining 118 patients (mean age, 5.0 [SE ± 0.3] years; 67% male) were used for correlation analysis. There was good correlation (Pearson correlation coefficient, r = 0.86) between estimated weight and measured weight. However, Bland-Altman analysis showed mean bias +2.6 kg (95% confidence interval [CI], 1.6-3.6 kg); lower/upper limits of agreement were -8.3 kg (CI, -10.0 to -6.6 kg) and 13.5 kg (CI, 11.7-15.2 kg).
It is possible to obtain an actual patient weight during pediatric trauma resuscitation. Length-based estimated weight using Broselow tape underestimated weight by 2.6 kg; the mean error was greatest in the highest weight category.
在儿科创伤/医疗复苏过程中获取准确体重至关重要。目前，采用基于身长的体重估计方法。本研究的目的是评估在创伤复苏期间获取儿童实际体重的可行性，并研究其与使用布罗泽洛小儿急救胶带进行的基于身长估计体重的一致性。
前瞻性纳入2008年11月至2009年10月期间到一家三级儿科创伤中心就诊的0至14岁儿科创伤患者。患者入院时使用布罗泽洛胶带进行基于身长的体重估计；此外，使用创伤担架集成称重秤记录患者的实际体重。
231例患者符合条件并被纳入研究。145名儿童（63.2%）记录了体重。27例患者（18.6%）的身长超过布罗泽洛胶带范围，仅使用担架秤测量了体重。其余118例患者（平均年龄5.0[标准误±0.3]岁；67%为男性）用于相关性分析。估计体重与测量体重之间存在良好相关性（皮尔逊相关系数，r = 0.86）。然而，布兰德-奥特曼分析显示平均偏差为+2.6 kg（95%置信区间[CI]，1.6 - 至3.6 kg）；一致性下限/上限分别为-8.3 kg（CI，-10.0至-6.6 kg）和13.5 kg（CI，11.7至15.2 kg）。
在儿科创伤复苏期间有可能获取患者的实际体重。使用布罗泽洛胶带进行的基于身长的估计体重低估了2.6 kg；平均误差在最高体重类别中最大。
