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Published on: February 2, 2017
Accurate estimation of body surface area in under-5 children with non-edematous severe acute malnutrition
Viswas Chhapola1, Sandeep Kumar Kanwal, Obeid Mohammad Shafi
1Division of Pediatric Intensive Care, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110001, India.
Insights
The Mosteller equation is accurate for calculating body surface area (BSA) in children with non-edematous severe acute malnutrition (NE-SAM). A new SAM Mosteller modified equation demonstrated the least error for BSA calculation in this population.
Area of Science:
- Pediatric Nutrition
- Biomedical Engineering
- Clinical Research
Background:
- Accurate body surface area (BSA) calculation is crucial for medical dosing and fluid management in children.
- Existing BSA equations may lack precision in specific pediatric populations, such as those with severe acute malnutrition (SAM).
Purpose of the Study:
- To evaluate the accuracy of commonly used BSA equations in non-edematous severe acute malnourished (NE-SAM) children.
- To develop and validate a novel BSA equation optimized for NE-SAM children.
Main Methods:
- Included 471 children aged 2 months to 5 years meeting WHO criteria for NE-SAM.
- Calculated BSA using seven established equations, with mean BSA serving as the reference.
- Derived and validated a new equation, 'SAM Mosteller modified', against existing ones.
Main Results:
- The Mosteller equation exhibited the lowest root mean square error (RMSE) among the seven initial equations (2.89).
- The novel SAM Mosteller modified equation demonstrated the least RMSE (2.65) when compared to Mosteller and Boyd equations in a subset of 66 NE-SAM children.
Conclusions:
- The Mosteller equation is a reliable option for BSA calculation in NE-SAM children.
- The 'SAM Mosteller modified' equation (164.551 × [Ht × Wt](0.5)) offers superior accuracy and is recommended for BSA estimation in SAM.
Objective:
To determine the accuracy of commonly used body surface area (BSA) equations and to devise a new equation for BSA calculation in non-edematous severe acute malnourished (NE-SAM) children.
Methods:
Children aged between 2 months and 5 years fulfilling World Health Organization criteria for NE-SAM were included. Seven commonly used equations were used for calculating the BSA. Mean BSA from the equations was used as reference for comparison. A new equation SAM Mosteller modified was also derived.
Results:
A total of 471 children were included. Of the seven equations, Mosteller had minimum root mean square error (RMSE) value of 2.89. The goodness of SAM Mosteller modified equation was subsequently compared with Mosteller and Boyd in 66 NE-SAM children. The SAM Mosteller modified showed least RMSE (2.65), whereas Boyd had maximum.
Conclusions:
Among seven equations, Mosteller is useful for BSA calculation in NE-SAM. SAM Mosteller modified equation (164.551 × [Ht × Wt](0.5)) has least error and can serve as best measure of BSA in SAM children.
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