Both Ch, Schmitz A, Buehler P K, Wittwer J, Weiss M, Schmidt A R
Department of Anaesthesia and Children's Research Centre, University Children's Hospital, Zurich, Switzerland.
Acta Anaesthesiol Scand. 2017 Oct;61(9):1122-1132. doi: 10.1111/aas.12949. Epub 2017 Aug 9.
Emergency tapes like the "Paediatric-Emergency-Ruler" (PaedER) provide drug dosing and recommend medical airway equipment based on estimated patient bodyweight and age. Previous studies have revealed unsatisfactory accuracy in bodyweight estimation, due to the tapes' length-based weight categories. Therefore, we developed a digital algorithm allowing continuous length-based estimation of weight and age. The aim of this study was to compare the new algorithm with the PaedER regarding accuracy in estimating bodyweight and recommendation of medical airway equipment.
Patients with a body length suitable for the PaedER were included in this single centre, prospective clinical observation trial after obtaining informed written parental consent. Bodyweight estimations by the algorithm and PaedER within ± 10% and ± 20% of the actual bodyweight were compared. Furthermore, medical airway equipment suggested by the PaedER and algorithm were compared with the equipment actually used for anaesthesia. Wilcoxon- and McNemar-Tests were used for statistical analysis. Results are median (interquartiles), P < 0.05 was considered significant.
In total, 489 patients aged 2.0 years (0.4-5.9), with a body length of 89.0 cm (63.5-114.5), weighing 12.8 kg (6.3-19.6), were included. The algorithm's precision of bodyweight estimation within ± 10%/± 20% was significantly higher at 64.0%/91.6% than the PaedER at 55.4%/81.8% (P < 0.001). Compared to PaedER the algorithm showed a higher incidence of correctly recommended medical airway equipment based on its accuracy for age and bodyweight estimation.
The new digital algorithm is an alternative to conventional emergency tapes, showing improved accuracy regarding length-based estimation of bodyweight and recommendation of medical airway equipment.
像“儿科急救尺”（PaedER）这样的急救卷尺可根据估计的患者体重和年龄提供药物剂量并推荐医用气道设备。先前的研究表明，由于卷尺基于长度的体重分类，其体重估计准确性不尽人意。因此，我们开发了一种数字算法，可基于长度连续估计体重和年龄。本研究的目的是将新算法与PaedER在估计体重的准确性和医用气道设备推荐方面进行比较。
在获得家长书面知情同意后，将身体长度适合使用PaedER的患者纳入这项单中心前瞻性临床观察试验。比较算法和PaedER对实际体重±10%和±20%范围内的体重估计。此外，将PaedER和算法建议的医用气道设备与实际用于麻醉的设备进行比较。采用Wilcoxon检验和McNemar检验进行统计分析。结果为中位数（四分位数间距），P<0.05被认为具有统计学意义。
总共纳入了489例年龄为2.0岁（0.4 - 5.9岁）、身长89.0厘米（63.5 - 114.5厘米）、体重12.8千克（6.3 - 19.6千克）的患者。算法在±10%/±20%范围内体重估计的精度显著高于PaedER，分别为64.0%/91.6%和55.4%/81.8%（P<0.001）。与PaedER相比，基于其对年龄和体重估计的准确性，算法正确推荐医用气道设备的发生率更高。
新的数字算法可替代传统急救卷尺，在基于长度估计体重和推荐医用气道设备方面显示出更高的准确性。
