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Precision of weight measurement in critically ill infants: a technical report
Ben Gelbart, Kate Masterson, Alyssa Serratore, Michael Zampetti, Andrea Veysey, Stacey Longstaff, Rinaldo Bellomo, Warwick Butt, Trevor Duke
Crit Care Resusc 2021; 23 (4): 414-417
- Ben Gelbart 1, 2, 3, 4
- Kate Masterson 1, 3
- Alyssa Serratore 1, 3
- Michael Zampetti 1, 3
- Andrea Veysey 1, 3
- Stacey Longstaff 1, 3
- Rinaldo Bellomo 4, 5, 6, 7, 8
- Warwick Butt 1, 2, 3, 4
- Trevor Duke 1, 2, 3
OBJECTIVES: To investigate the precision of weight measurements in critically ill infants in a paediatric intensive care unit (PICU).
DESIGN: Prospective cohort study.
SETTING: Royal Children's Hospital PICU.
PARTICIPANTS: Mechanically ventilated infants admitted to the Royal Children's Hospital PICU between September 2020 and February 2021.
MAIN OUTCOME MEASURES: Mean percentage difference and agreement of consecutive weight measurements.
RESULTS: Thirty infants were enrolled, of which 17 were receiving post-surgical care for congenital heart disease and four were receiving extracorporeal membrane oxygenation (ECMO). The median age was 13 days (interquartile range [IQR], 3.1–52.4 days). The mean difference in weight was 1.3% (standard deviation [SD], 1.0%), and the test–retest agreement intraclass correlation was 0.99 (95% CI, 0.99–0.99; P < 0.01). The percentage difference between measurements was ≤ 2.5% in 26/30 (87%) children, and the range was < 0.1% to 3.6%. In 26 children not receiving ECMO, the mean difference in weight was 1.1% (SD, 1.0%). There were no complications.
CONCLUSIONS: Weighing mechanically ventilated, critically ill infants in intensive care can be performed safely, with a mean difference between consecutive weights of 1.3%, making it a potentially useful additional measure of fluid accumulation.
- Alobaidi R, Morgan C, Basu RK, et al. Association between fluid balance and outcomes in critically ill children: a systematic review and meta-analysis. JAMA Pediatr 2018; 172: 257-68.
- Alobaidi R, Basu RK, DeCaen A, et al. Fluid accumulation in critically ill children. Crit Care Med 2020; 48: 1034-41.
- Schneider AG, Baldwin I, Freitag E, et al. Estimation of fluid status changes in critically ill patients: fluid balance chart or electronic bed weight? J Crit Care 2012; 27: 745.e7-12.
- Schneider AG, Thorpe C, Dellbridge K, et al. Electronic bed weighing vs daily fluid balance changes after cardiac surgery. J Crit Care 2013; 28: 1113.e1-5.
- Bontant T, Matrot B, Abdoul H, et al. Assessing fluid balance in critically ill pediatric patients. Eur J Pediatr 2015; 174: 133-7.
- Ahearn MA, Soranno DE, Stidham T, et al. Adherence to daily weights and total fluid orders in the pediatric intensive care unit. Pediatr Qual Saf 2018; 3: e110.
- You JW, Lee SJ, Kim YE, et al. Association between weight change and clinical outcomes in critically ill patients. J Crit Care 2013; 28: 923-7.
- Akcan-Arikan A, Gebhard DJ, Arnold MA, et al. Fluid Overload and Kidney Injury Score: a multidimensional real-time assessment of renal disease burden in the critically ill patient. Pediatr Crit Care Med 2017; 18: 524-30.
- Sutherland S, Zappitelli M, Alexander S, et al. Fluid overload and mortality in children receiving continuous renal replacement therapy: the Prospective Pediatric Continuous Renal Replacement Therapy Registry. Am J Kidney Dis 2010; 55: 316-25.
- Gist KM, Selewski DT, Brinton J, et al. Assessment of the Independent and Synergistic Effects of Fluid Overload and Acute Kidney Injury on Outcomes of Critically Ill Children. Pediatr Crit Care Med 2020; 21: 170-7.