Prescribing in obese children: how good are paediatricians?

2016 ◽  
Vol 102 (1) ◽  
pp. 61-62 ◽  
Author(s):  
Helen Collier ◽  
Maria Nasim ◽  
Anjum Gandhi
Keyword(s):  
Body Weight ◽  
Childhood Obesity ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Obese Children ◽  
Poor Understanding ◽  
Drug Doses ◽  
Ideal Body ◽  
Total Body ◽  
The Ideal

Childhood obesity is increasing nationally and worldwide. Using the child's total body weight to calculate drug doses for certain medications could result in incorrect dosing. The aim of this study was to assess whether paediatric doctors have knowledge about prescribing correct doses of medications for obese children by using methods to calculate the ‘ideal body weight’ (IBW). A questionnaire was sent to paediatric doctors asking whether they understand IBW and how to calculate it using the McLaren method. The results suggested that most paediatric doctors did not determine whether a child was obese when calculating drug doses. There was relatively poor understanding about the concept of IBW and only 9% of paediatricians in this study knew how to calculate it. There should be more training and guidance about calculating IBW in obese children to avoid potentially toxic errors.

985: SEDATION DOSING BASED ON IDEAL BODY WEIGHT VERSUS TOTAL BODY WEIGHT IN THE INTENSIVE CARE UNIT

2018 ◽  
Vol 46 (1) ◽  
pp. 476-476
Author(s):  
Julianne Yeary ◽  
Alexandra Greco ◽  
Rich Mcknight ◽  
Karen Petros ◽  
Jefferey Garavaglia
Keyword(s):  
Intensive Care Unit ◽  
Body Weight ◽  
Intensive Care ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Ideal Body ◽  
Total Body

scholarly journals Comparative evaluation of atracurium dosed on ideal body weight vs. total body weight in morbidly obese patients

2010 ◽  
Vol 71 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Simone Van Kralingen ◽  
Ewoudt M. W. Van De Garde ◽  
Catherijne A. J. Knibbe ◽  
Jeroen Diepstraten ◽  
Marinus J. Wiezer ◽  
...  
Keyword(s):  
Body Weight ◽  
Comparative Evaluation ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Ideal Body ◽  
Total Body

Theophylline Clearance in Obese Patients in Relation to Smoking and Congestive Heart Failure

1983 ◽  
Vol 17 (4) ◽  
pp. 274-276 ◽  
Author(s):  
Richard L. Slaughter ◽  
Robert A. Lanc
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Body Weight ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Obese Patients ◽  
Ideal Body ◽  
Total Body ◽  
Nonobese Patients ◽  
Body Clearance

The effect of obesity on the total body clearance (Cltot) of theophylline was evaluated in nonsmokers and smokers with and without congestive heart failure (CHF). The obese patients were compared with similar nonobese subjects with regard to age, sex, and disease state. The total patient population numbered 150 adults. Cltot of theophylline, based on total body weight (TBW), averaged 0.60 ± 0.20 ml/min/kg in obese nonsmokers and did not differ from the nonobese, nonsmoking group. In obese nonsmoking patients with CHF, Cltot based on TBW was 0.40 ± 0.14 ml/min/kg, which was similar to Cltot values in nonsmoking CHF patients who were not obese. A trend toward a reduction in Cltot, based on TBW, as TBW increased, in nonsmoking patients with and without CHF, was observed. In contrast to the Cltot in nonsmokers, the Cltot of theophylline in obese smokers with and without CHF was similar to the Cltot values in nonobese populations only when based on ideal body weight. However, when compared with nonsmoking, nonobese patients, no differences were observed when Cltot was corrected for TBW. These findings suggest that theophylline maintenance dose can be based on TBW in obese patients who are smokers and nonsmokers (with and without CHF), using the average Cltot obtained for the nonsmoking patients with and without CHF.

scholarly journals 2109. Liposomal Amphotericin B-associated Nephrotoxicity in Obese and Non-obese Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S714-S714
Author(s):  
Brandon Tritle ◽  
Logan Peterson ◽  
Jared Olson ◽  
Emily Benefield ◽  
Paloma F Cariello ◽  
...  
Keyword(s):  
Body Weight ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Liposomal Amphotericin B ◽  
Obese Patients ◽  
Daily Dose ◽  
Ideal Body ◽  
Total Body

Abstract Background Liposomal amphotericin B (L-amb) is an important antifungal agent which exhibits significant rates of dose-dependent nephrotoxicity. Animal studies demonstrate only small amounts of L-amb distribute into adipose tissue and obese animals show greater risk of nephrotoxicity with L-amb administration. This study aims to determine whether obese patients are at a higher risk of nephrotoxicity with weight-based doses of L-amb. Methods We performed a multi-center, retrospective cohort study of nephrotoxicity with L-amb in obese (BMI > 30) and non-obese adult patients at University of Utah Health and Intermountain Healthcare from January 1, 2014 through December 31, 2018. Our primary outcome was the rate of nephrotoxicity as determined by AKIN criteria. Patients receiving at least one dose of L-amb were identified for inclusion. Patients were excluded if they were already on a renal replacement at the time of L-amb initiation or they received L-amb prior to admission. Results We included 221 patients, 47 (21%) were obese and 174 (79%) were non-obese. Median total body weight was 109 kg in obese patients compared with 70 kg in non-obese patients. Dosage based on ideal body weight was higher in the obese group (median 6.9 mg/kg vs. 4.9 mg/kg). Obese patients were significantly more likely to experience acute kidney injury (AKI) than non-obese patients (55% vs. 37%, P = 0.03). Patients who experienced nephrotoxicity received a higher average daily dose than those who did not (365 mg vs. 333 mg, P = 0.03), had a higher median cumulative dose (3,130 mg vs. 1,700 mg, P < 0.001), and had a higher median total body weight (79.6 kg vs. 71.9 kg, P = 0.04.). Additionally, daily dose normalized to total body weight was not associated with AKI (median 4.7 mg/kg in patients with AKI vs. 4.8 mg/kg in patients without AKI, P = 0.86). However, daily dose normalized to ideal body weight was associated with AKI (median 5.5 mg/kg in patients with AKI vs. 4.9 mg/kg in patients without AKI, P = 0.02). Conclusion We identified a higher rate of nephrotoxicity among obese patients receiving L-amb compared with non-obese patients. These data suggest that dosing L-amb based on total body weight places obese patients at a higher risk of nephrotoxicity. This should be considered when assessing the risks and benefits of this dosing strategy in obese patients. Disclosures All authors: No reported disclosures.

scholarly journals Using the Mercy Method to Estimate Ideal Body Weight in Children – A Description and Validation of a New Methodology

2020 ◽  
Author(s):  
Mike Wells ◽  
Lara Nicole Goldstein
Keyword(s):  
Body Weight ◽  
Obese Child ◽  
A Priori ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Estimation Accuracy ◽  
Accurate Estimation ◽  
Obese Children ◽  
Ideal Body ◽  
Estimation System

ABSTRACTBackgroundIn obese children, lipophilic medications should be dosed to total body weight (TBW) and hydrophilic medications to ideal body weight (IBW). During emergencies these weights need to be estimated to ensure that urgent drug therapy is accurate and safe. The Mercy method is a well-established weight estimation system that has recently been adapted to provide estimations of body length in children. It was therefore conceivable that this could be further modified to provide estimations of IBW.MethodsA model was developed a priori using the Mercy method’s humeral length segments to predict IBW. The accuracy of this model was then tested in a sample of 13134 children from the National Health and Nutrition Examination Survey (NHANES) datasets. The accuracy of IBW estimation was determined from the percentage of estimations falling within 10% (p10) and 20% (p20) of true IBW. The model was also tested to see the accuracy of detection of obesity in the study sample.ResultsFrom the sample of 13134 children, a subset of 1318 obese children were identified. In this subset, the new Mercy method model achieved an IBW estimation accuracy p10 of 66.9% and a p20 of 95.1%. For the detection of the obese child, the model had a sensitivity of 88.6% and a specificity of 75.8%.ConclusionsThis study established that the Mercy method can be modified to provide a reasonably accurate estimation of IBW in obese children, with very few critical errors. The ability to the model to identify the obese child was also reasonably accurate, on a par with other such predictive methods. While other accurate methods of estimating both TBW and IBW exist, such as the PAWPER XL tape, the modified Mercy method is an acceptable alternative if such other devices are not available.

Weight and Menstrual Function in Patients with Eating Disorders and Cystic Fibrosis

PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 522-522
Author(s):  
ALBERT C. HERGENROEDER
Keyword(s):  
Cystic Fibrosis ◽  
Eating Disorders ◽  
Body Weight ◽  
Growth Curves ◽  
Ideal Body Weight ◽  
Menstrual Function ◽  
Ideal Body ◽  
The Ideal

To the Editor.— This letter is in response to the article entitled "Weight and Menstrual Function in Patients with Eating Disorders and Cystic Fibrosis."1 Under "Methods," the authors describe a method for calculating percent ideal body weight by plotting the patient's height on standard growth curves derived from the data of Hamill et al,2 and the ideal body weight being the weight at the same percentile for age. Using the tables of Hamill to calculate percentages of height and weight for females older than 10 years and males older than 11½ years should be done cautiously.

scholarly journals Classification of Human Weight Based on Image

2019 ◽  
Vol 13 (2) ◽  
pp. 105
Author(s):  
Shofwatul 'Uyun ◽  
Toni Efendi
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Ideal Body Weight ◽  
Detection Algorithm ◽  
The Body ◽  
Weight Category ◽  
Ideal Body ◽  
The Ideal

Classification of human weight can be determined by body mass index. The body mass index can be calculated by dividing the height by the square of the body weight. According to researchers, this is less practical, so it needs to make a tool that can be used to determine ideal body weight more practically. One way is to use an Android smartphone camera. The camera is used to capture the image of the human body. Then the image is processed by using digital image processing and by using certain algorithms, so it may conclude the person's ideal weight category. The data used in this study are human photos, body weight and height. There are four stages to determine the weight and height based on the image. First, performing an analysis of the calculation of the derived formulas. Second, analyzing the edge detection algorithm. Third, conducting unit convertion, and fourth, proposing several algorithms to calculate the height and weight used to determine the ideal body weight. The results of the evaluation show that Algorithm C (measuring the width of an object starting with the height of the image adjusting half of the height of the object in the image) is the best algorithm with deviation value of 1.85% of the height and 8.87% of the weight, while the system accuracy rate in determining the ideal body weight has reached 78.7%. 

scholarly journals The Maintenance Management of Broiler Chicken in Achieving Ideal Body Weight (Case Study in RRMC "Rurel Rearing Multivication Center " Puubunga, Indonesia)

2017 ◽  
Vol 2 (2) ◽  
pp. 7-12
Author(s):  
Rin Orin Ningrum
Keyword(s):  
Body Weight ◽  
Broiler Chicken ◽  
Ideal Body Weight ◽  
Maintenance Management ◽  
Maintenance Period ◽  
Productivity Level ◽  
Chicken Farm ◽  
Ideal Body ◽  
The Ideal

The broiler chicken farm at RRMC has good maintenance management and feeding procedures. The productivity level of the livestock had been achieved and it meets the standard market weight of 2 kg for one maintenance period of 35 days. The shape of the coop in the RRMC is a semi-monitor whose coop location faces the rising sun, so the chicken can get direct morning sunlight. Preparation of the coop at the time of DOC comes is very important because the coop should be sterile from various seeds of disease. Whether it comes from fungi, viruses, bacteria and protozoa. In addition, during maintenance, employees must be diligent in controlling the existing chicken in the coop and see the condition of feed and drink that must be given ad libitum in order to produce the ideal body weight according to the wishes of the entrepreneur and its customers. The results of the research, it can be concluded that maintenance management in RRMC very clear and in accordance with existing procedures, whether it is feeding, handling of diseases affected by disease, vaccine and drugs.

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