1/17/2024 0 Comments Calculating tidal volumeMeasurements and calculations Height measurementĮxact height in the erect position ( actual height) was considered the gold standard and was performed for all 60 healthy volunteers, using a standard clinical height gauge. This prospective observational protocol was in accordance with the standards of our local ethics committee informed consent was not deemed necessary because of the observational nature of the study. In this study, we first analyzed on 60 healthy volunteers whether estimated height using various simple anthropometric formulas will agree with the exact measured height, and in second whether several formulas will help setting tidal volume in 60 mechanically ventilated ICU patients. Several other ICU team use height and weight estimates, but these visual estimations have yet been demonstrated as significantly inaccurate for individual observers. In fact, actual body weight is often used in routine, which can lead to large errors in tidal volume settings, especially in women and obese patients that are consistently at risk of unintentional delivery of excessive tidal volumes. Although recumbent patients’ height can be measured by means of a metric ribbon tape, this measurement is not always performed or may lack consistency. However, height measurement is not a daily routine in all ICUs. Because it is well established that patients’ lungs are well correlated with their height, accurate tidal volume setting should be based on ideal or predicted body weight that is functions of height and gender, rather than on actual weight to avoid acquired acute lung injury and ARDS and to improve outcome. Knowledge of patients’ height is essential for daily practice in the intensive care unit (ICU), for either assessment of renal function, determination of drug doses, calculating cardiac function indices, or tidal volume setting. The simplified Chumlea method is easy to achieve in a bed-ridden patient and provides accurate height estimates, with a low bias. When actual height is unavailable in ICU patients undergoing mechanical ventilation, alternative anthropometric methods to obtain patient’s height based on lower leg and on forearm measurements could be useful to facilitate the application of protective mechanical ventilation in a Caucasian ICU population. In most cases, tidal volume set according to these estimates was lower than what would have been set using the actual weight. All these height estimates allowed calculating IBW or PBW that were significantly different from the patients’ actual weight on admission. Ulna and tibia estimates also provided valuable estimates. In the 60 ICU patients, calculated height using the simplified Chumlea method was well correlated with measured height ( r = 0.78 ∂ < 1 %). The Chumlea method and its simplified version, performed in the supine position, provided adequate estimates. Correlation was low between actual and calculated height, using the hand’s length and width, the index, or the foot equations. In the 60 healthy volunteers, actual height was well correlated with the gold standard, measured height in the erect position. During the second phase, four height estimates were performed on 60 consecutive ICU patients under mechanical ventilation. During the first phase of the study, eight limb measurements were performed on 60 healthy volunteers and 18 height estimation formulas were tested. This was a prospective, observational study in a medical intensive care unit of a university hospital. The objectives of the study were to evaluate several anthropometric formulas for height estimation on healthy volunteers and to test whether several of these estimates will help tidal volume setting in ICU patients. Clinicians do need simple and rapid methods to estimate the patients’ height, especially in short height and/or obese patients. However, actual height measurements are unavailable on a daily routine in the ICU and measured height in the supine position and/or visual estimates may lack consistency. Knowledge of patients’ height is essential for daily practice in the intensive care unit.
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