Lean Body Mass Is Better Than Body Surface Area in Correcting GFR

For over four decades, pump flow rate during cardio-pulmonary bypass (CPB) has been estimated using body surface area (BSA). As patients presenting for heart surgery are increasingly obese, this approach may no longer be appropriate and other estimates of systemic metabolism should be used, such as body mass index and lean body mass. Mixed venous oxygen saturation (SvO2) is a robust and independent estimate of the global efficacy of CPB. The aim of this study was to determine which factors, including body surface area, body mass index and lean body mass, best predict SvO2 during CPB. Forty-eight patients undergoing elective cardiac surgery requiring CPB were studied. Patients’ height, weight and skinfold thickness at four sites (biceps, triceps, subscapularis and suprailiac) were measured. Body surface area, lean body mass and body mass index were then calculated. Pump flow rate was maintained at 2.4 L/min/m2 during CPB as per standard unit protocol. Arterial and mixed venous blood samples were taken during the cooling, stable hypothermia and rewarming phases of CPB. Nasopharyngeal temperatures and flow rates were recorded contemporaneously. The blood samples were analysed for oxygen saturation, haemoglobin concentration and partial pressures of oxygen and carbon dioxide. The values of the three time points were meaned. All potential predictor variables were then univariately correlated with mixed venous oxygen saturation (SvO2). Those correlating significantly ( p < 0.1) were entered into a multivariate linear regression model. Nasopharyngeal temperature (β=0.615, p < 0.001) and lean body mass (β=0.256, p < 0.028) were the only significant predictors of SvO2 ( r2= 0.433, p < 0.001). Pump flow rates maintained at 2.4 L/min/m2 throughout CPB results in relative over-perfusion during hypothermia. Lean body mass may be a more sensitive estimate of systemic metabolism and, therefore, may provide a more accurate means of determining pump flow rate than body surface area in patients undergoing heart surgery.

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Lean body mass, body surface area and epirubicin kinetics

Anti-Cancer Drugs ◽

10.1097/00001813-199406000-00005 ◽

1994 ◽

Vol 5 (3) ◽

pp. 293-297 ◽

Cited By ~ 19

Author(s):

Walter C Cosolo ◽

Denis J Morgan ◽

Ego Seeman ◽

Allan S Zimet ◽

Joe J McKendrick ◽

...

Keyword(s):

Surface Area ◽

Body Surface Area ◽

Lean Body Mass ◽

Body Mass ◽

Body Surface

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Lean body mass and total body weight versus body surface area as determinant of docetaxel pharmacokinetics and toxicity

10.22541/au.164226811.14665958/v1 ◽

2022 ◽

Author(s):

Rien Hoge ◽

Suzan Detert Oude Weme ◽

Walter Vervenne ◽

Inge van Berlo - van de Laar ◽

Carla van Herpen ◽

...

Keyword(s):

Body Composition ◽

Body Weight ◽

Surface Area ◽

Body Surface Area ◽

Lean Body Mass ◽

Body Mass ◽

Body Surface ◽

Total Body Weight ◽

Dose Individualisation ◽

Total Body

Aim: In our study we examined whether anthropometric and body composition parameters, i.e. body surface area (BSA), lean body mass (LBM) and total body weight (TBW), are correlated with docetaxel clearance and exposure. In addition, LBM, TBW and a fixed dose were compared to BSA as dosing parameters for dose individualisation of docetaxel. Methods: Thirty-six patients affected by breast or castration-resistant prostate carcinoma receiving docetaxel chemotherapy entered the study. LBM was measured by a Dual Energy Xray Absorptiometry (DEXA) scanner before treatment. Blood samples were collected up to 180 minutes after dosing to analyse docetaxel concentrations and to determine individual pharmacokinetic (PK) parameters. Results: No significant correlations were found between the docetaxel pharmacokinetic parameters clearance and volume of distribution and the anthropometric and body composition variables BSA, LBM and TBW. AUC was significantly but poorly correlated with BSA (r=0.452 [p=0.016]) and with TBW (r=0.476 (p=0.011]). The Mean Absolute Percentage Error and Mean Error of simulated dosing based on LBM and fixed dosing ME were not significant different compared to BSA. For TBW, only the MAPE of dosing was significant higher compared to BSA (24.1 vs. 17.1, P=0.001). Conclusion: There is no correlations between docetaxel pharmacokinetics and the anthropometric and body composition variables BSA, LBM and TBW. Dose individualisation of docetaxel based on LBM or TBW or fixed dosing cannot be recommended over BSA based dosing.

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Body Mass Index and Body Surface Area and Their Associations with Outcomes in Stage II and III Colon Cancer

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-012-9472-4 ◽

2012 ◽

Vol 44 (2) ◽

pp. 203-210 ◽

Cited By ~ 10

Author(s):

Sina Alipour ◽

Hagen F. Kennecke ◽

Ryan Woods ◽

Howard J. Lim ◽

Caroline Speers ◽

...

Keyword(s):

Body Mass Index ◽

Colon Cancer ◽

Surface Area ◽

Body Surface Area ◽

Body Mass ◽

Body Surface ◽

Stage Ii

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Psoriasis: Moderne Versorgung braucht einen ganzheitlichen Ansatz

Karger Kompass Dermatologie ◽

10.1159/000503434 ◽

2019 ◽

pp. 196-197

Author(s):

Natalia Kirsten

Keyword(s):

Surface Area ◽

Body Surface Area ◽

Body Mass ◽

Body Surface ◽

Vitamin D3 ◽

Severity Index ◽

Serum Concentrations ◽

Depression Severity ◽

Interleukin 18 ◽

Psoriasis Area Severity Index

Objective: Psoriasis and depression may have common mechanisms, such as systemic inflammation, dysfunction of the hypothalamic-pituitary-adrenal axis, and vitamin D3 deficiency. Among men with psoriasis, this study examined whether depression severity was associated with serum concentrations of different metabolic and inflammatory markers.Methods: The study included 85 men with psoriasis (mean age ±standard deviation [SD], 47 ±14 years) and 65 men without psoriasis (mean age ±SD, 44 ±13 years). In both groups, we measured the body mass index; blood pressure; and serum concentrations of lipids, uric acid, lipase, interleukins 6 and 18, cortisol, and 25-hydroxyvitamin D3. All participants completed the Beck Depression Inventory. Other variables analyzed included psoriasis duration, the Psoriasis Area Severity Index, and the percentage of body surface area affected by psoriatic lesions.Results: Compared with controls, patients with psoriasis had significantly greater depression severity, higher body mass indices, and higher serum concentrations of total cholesterol and interleukins 6 and 18; moreover, they had significantly lower serum 25-hydroxyvitamin D3 concentrations. In patients with psoriasis, depression severity correlated positively with psoriasis duration, the Psoriasis Area Severity Index, the percentage of body surface area affected by psoriatic lesions, and interleukin-18 concentration. In patients with psoriasis, depression severity correlated negatively with 25-hydroxyvitamin D3 concentration, but it did not correlate significantly with the serum concentrations of interleukin 6 and cortisol. Conclusion: High concentrations of interleukin 18 and low concentrations of 25-hydroxyvitamin D3 may be associated with depression severity in men with psoriasis. Thus, further studies should examine whether effective anti-inflammatory treatments or vitamin D3 supplementation can improve depression outcomes in these patients.

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