Young Timothy P, Washington Omar, Flanery Andrew, Guptill Mindi, Reibling Ellen T, Brown Lance, Barcega Besh
Division of Paediatric Emergency Medicine, Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA, USA.
Emerg Med Australas. 2015 Jun;27(3):239-44. doi: 10.1111/1742-6723.12382. Epub 2015 Mar 26.
We sought to evaluate commonly used paediatric weight estimation techniques in a sample of children in the Philippines.
We prospectively collected age, height and weight data for a sample of 207 children aged 1-9 years seen during a medical aid trip. Weights were estimated using the finger counting method, the Broselow method and four formulae. Bland-Altman analysis was performed to evaluate agreement with measured weight.
Mean difference and range of agreement in kilograms were as follows: 0.6 (95% CI 0.1-1.1) and 14.9 (95% CI 13.1-16.7) for the Broselow method; 1.1 (95% CI 0.5-1.7) and 17.3 (95% CI 15.2-19.3) for the traditional APLS formula; 3.1 (95% CI 2.4-3.7) and 18.6 (95% CI 16.4-20.8) for the finger counting method; 4.0 (95% CI 3.2-4.8) and 23.1 (95% CI 20.3-25.8) for the updated APLS method; 5.1 (95% CI 4.4-5.8) and 21.1 (95% CI 18.6-23.6) for the Luscombe formula; and 5.3 (95% CI 4.5-6.1) and 22.5 (95% CI 20-25.2) for the Best Guess formulae.
The Broselow tape and the traditional APLS formula performed best in our sample. The finger counting method also outperformed newer weight estimation formulae. 'Updated' age-based formulae created recently in developed countries should not be used in disaster relief efforts in the Philippines. Caution should be used when applying these formulae to other developing countries and in disaster response.
我们试图在菲律宾的一组儿童样本中评估常用的儿科体重估计技术。
我们前瞻性地收集了在一次医疗援助行程中见到的207名1 - 9岁儿童样本的年龄、身高和体重数据。使用手指计数法、布罗泽洛法和四个公式来估计体重。进行布兰德 - 奥特曼分析以评估与实测体重的一致性。
以千克为单位的平均差异和一致性范围如下:布罗泽洛法为0.6(95%置信区间0.1 - 1.1)和14.9(95%置信区间13.1 - 16.7);传统APLS公式为1.1(95%置信区间0.5 - 1.7)和17.3(95%置信区间15.2 - 19.3);手指计数法为3.1(95%置信区间2.4 - 3.7)和18.6(95%置信区间16.4 - 20.8);更新后的APLS方法为4.0(95%置信区间3.2 - 4.8)和23.1(95%置信区间20.3 - 25.8);卢斯科姆公式为5.1(95%置信区间4.4 - 5.8)和21.1(95%置信区间18.6 - 23.6);最佳猜测公式为5.3(95%置信区间4.5 - 6.1)和22.5(95%置信区间20 - 25.2)。
在我们的样本中,布罗泽洛卷尺和传统APLS公式表现最佳。手指计数法也优于更新的体重估计公式。发达国家最近创建的“更新的”基于年龄的公式不应在菲律宾的救灾工作中使用。将这些公式应用于其他发展中国家和灾害应对时应谨慎。