RT Journal Article
SR Electronic
T1 Comparison of Usual and Alternative Methods to Measure Height in Mechanically Ventilated Patients: Potential Impact on Protective Ventilation
JF Respiratory Care
FD American Association for Respiratory Care
SP 1025
OP 1033
DO 10.4187/respcare.02732
VO 59
IS 7
A1 Bojmehrani, Azadeh
A1 Bergeron-Duchesne, Maude
A1 Bouchard, Carmelle
A1 Simard, Serge
A1 Bouchard, Pierre-Alexandre
A1 Vanderschuren, Abel
A1 L'Her, Erwan
A1 Lellouche, François
YR 2014
UL http://rc.rcjournal.com/content/59/7/1025.abstract
AB BACKGROUND: Protective ventilation implementation requires the calculation of predicted body weight (PBW), determined by a formula based on gender and height. Consequently, height inaccuracy may be a limiting factor to correctly set tidal volumes. The objective of this study was to evaluate the accuracy of different methods in measuring heights in mechanically ventilated patients. METHODS: Before cardiac surgery, actual height was measured with a height gauge while subjects were standing upright (reference method); the height was also estimated by alternative methods based on lower leg and forearm measurements. After cardiac surgery, upon ICU admission, a subject's height was visually estimated by a clinician and then measured with a tape measure while the subject was supine and undergoing mechanical ventilation. RESULTS: One hundred subjects (75 men, 25 women) were prospectively included. Mean PBW was 61.0 ± 9.7 kg, and mean actual weight was 30.3% higher. In comparison with the reference method, estimating the height visually and using the tape measure were less accurate than both lower leg and forearm measurements. Errors above 10% in calculating the PBW were present in 25 and 40 subjects when the tape measure or visual estimation of height was used in the formula, respectively. With lower leg and forearm measurements, 15 subjects had errors above 10% (P < .001). CONCLUSIONS: Our results demonstrate that significant variability exists between the different methods used to measure height in bedridden patients on mechanical ventilation. Alternative methods based on lower leg and forearm measurements are potentially interesting solutions to facilitate the accurate application of protective ventilation.