Comparison of Body Weights Via Visual Estimation, Anthropometric Calculation, and Actual Measured in Critically Ill Patients

February 17, 2024 updated by: Nazlıhan Boyacı Dündar, Gazi University

Evaluation of the Relation of the Body Weight Calculated by Visual Estimation and Anthropometric Measurements to the Actual Body Weight Measured by the Patient Transfer Scale in Critically Ill Patients

Rapid and accurate determination of body weight in adult intensive care patients is very important for both calculating target tidal volume during invasive mechanical ventilation support and dose dependent drug administration. In this patient group, measuring actual body weight with a calibrated scale by standing the patient up is often impossible due to acute illness. Instead, estimated body weight determined by health care personnel or estimated body weights calculated according to anthropometric measurements are used. These calculations have some limitations in showing actual body weight, and there is some controversial information in current literature regarding their validity in critically ill patients. There is newly developed patient transfer scale called Marsden M-999® manufactured by Marsden Weighing Machine Group Ltd, which has the advantage of being used in patients who are unable to stand up, in rapidly and accurately measuring the current body weight in critically ill patients. This study aimed to evaluate the validity of these methods by comparing the body weights calculated by visual estimation and various anthropometric methods in critically ill Turkish patients with the actual weight measured by the mentioned scale.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

In adult medicine, determining the patient's body weight by visual estimation performed by healthcare providers (nurses and doctors) is common for critically ill patients who cannot speak or stand due to acute illnesses such as loss of consciousness, circulatory shock, or acute respiratory failure. This practice often leads to the administration of the same dose of medication to many patients whose body weight may vary between 50 to 100 kilograms (kg). In cases where rapid diagnosis and treatment are crucial due to acute illness, the accurate and effective administration of dose-dependent drugs such as antibiotics, anticoagulants, vasopressors, sedatives, and analgesics is essential for treatment success. Although the average error percentage of 10-20% in estimated body weight by visual estimation may seem negligible in emergencies, it can lead to increased toxicity and costs in recombinant factor replacements, anticoagulants with a narrow therapeutic range, and various imported antibiotics. Additionally, the high error rate in estimating height by visual estimation poses a risk of causing ventilator-induced lung injury (VILI) during invasive mechanical ventilation support by inducing alveolar overdistension.

Various calculation methods have been reported for estimating body weight based on anthropometric measurements. One such method is weight calculation based on the upper mid-arm circumference (UMAC), which has been reported as the most correlated calculation for actual body weight in the adult age group in studies using National Health and Nutrition Examination Survey (NHANES) data in the United States (U.S.). Another commonly used method is formulas that calculate ideal body weight based on the patient's height. This is especially crucial in critically ill patients during invasive mechanical ventilation support for acute respiratory failure. The calculation of ideal body weight using charts based on half-span or knee height can be applied in cases where patients cannot stand due to critical illness.

Many anthropometric measurements mentioned here have been conducted in different societies. They may vary according to ethnic communities, emphasizing the potential differences in body composition, such as fat and muscle mass distribution, among different ethnic groups. Considering the critical illness in the Turkish population, there is currently no detailed publication in the literature regarding the usability of estimated body weights calculated based on anthropometric measurements. Moreover, the fact that many anthropometric measurements are derived from population screening data in healthy individuals causes their application in clinical practice challenging. Validity of anthropometric measurements that apply to critically ill patients, where patients cannot stand, appropriate positions for anthropometric measurements cannot be provided, and body distributions in limbs where anthropometric measurements are derived may differ due to peripheral edema, is, therefore, crucial.

In many studies using anthropometric measurements for weight calculation, the actual body weights of patients were measured using a calibrated scale. Given that critically ill patients often cannot be lifted due to acute illness, special devices or equipments are needed to reliably determine actual body weights in the supine position in this patient group. Currently, used bed scales, wall-mounted levers, or special devices that allow the patient and bed to be weighed together are not widely used due to high costs and difficulties associated with patient transfer from bed to bed, such as the need for the patient to be hemodynamically stable, the need for multiple personnel during patient transfer, adherence to infection prevention rules, and the time-consuming nature of measurements depending on the device used. The recently developed patient transfer scale, Marsden M-999®, which has advantages for patients who cannot stand, suggests that it could be used to calculate actual weight rapidly and accurately in critically ill patients. There is no publication currently in the literature about the routine use of the mentioned patient transfer scale in critically ill settings. However, its ease of use in measuring patient body weight in the supine position while transitioning from a stretcher to an intensive care bed is a significant advantage.

Considering that the patient transfer scale cannot be provided to every intensive care unit due to its cost; it was aimed to determine the most valid estimated body weight calculation method in the critically ill Turkish patients according to anthropometric measurements in this study.

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Nazlıhan Boyacı Dündar, asist. prof.
  • Phone Number: +903122024241
  • Email: nazlihan@gazi.edu.tr

Study Contact Backup

Study Locations

  • Turkey
    • Yenimahalle
      • Ankara, Yenimahalle, Turkey, 06560
        • Recruiting
        • Gazi University
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Patients who can stand without assistance are admitted to the inward of the internal disease department.
  2. Patients who are admitted to the medical intensive care units

Exclusion Criteria:

  1. Patient or control group under the age of 18 years
  2. Patients died within the first 8 hours after hospital admission
  3. Patients who did not sign informed consent
  4. Refusal of legal representative to participate in the study in unconscious patients
  5. Patients with anatomical defects or limb instruments that would prevent performing anthropometric measurements

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Screening
  • Allocation: Non-Randomized
  • Interventional Model: Sequential Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: inward patients
The inward patients who will be weighed with bathroom scale and patient transfer scale
Device: patient transfer scale
patient transfer scale is a device to measure actual weight for critically ill patient who are unable to stand
Other: critically ill patients
The critically ill patients who will be weighed with patient transfer scale
Device: patient transfer scale
patient transfer scale is a device to measure actual weight for critically ill patient who are unable to stand

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
determining actual weight
Time Frame: Actual body weight measured with bathroom scales and patient transfer scales in standing patients on the day of hospital; up to 8 weeks for purpose of reaching total patients number of 100
The correlation between actual weight measured with bathroom scales and patient transfer scales in standing patients
Actual body weight measured with bathroom scales and patient transfer scales in standing patients on the day of hospital; up to 8 weeks for purpose of reaching total patients number of 100
determining the ideal estimated body weight in critically ill patients
Time Frame: Actual and estimated weight of patients determined on the first day of intensive care unit; up to 6 months for purpose of reaching total patients number of 100
The correlation of actual weight with estimated weight determined based on visual estimation and anthropometric measurements in critically ill
Actual and estimated weight of patients determined on the first day of intensive care unit; up to 6 months for purpose of reaching total patients number of 100

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gazi University

Investigators

  • Principal Investigator: Nazlıhan Boyacı Dündar, asist. prof., Gazi University, Faculty of Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2023

Primary Completion (Estimated)

August 31, 2024

Study Completion (Estimated)

October 31, 2024

Study Registration Dates

First Submitted

February 10, 2024

First Submitted That Met QC Criteria

February 17, 2024

First Posted (Estimated)

February 21, 2024

Study Record Updates

Last Update Posted (Estimated)

February 21, 2024

Last Update Submitted That Met QC Criteria

February 17, 2024

Last Verified

February 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • GaziUtipNBDundar003

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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