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At least 19 recordsLinked to original sources
PubMed1994

Normalization of glomerular filtration rate in children: body surface area, body weight or extracellular fluid volume?

UNLABELLED: Glomerular filtration rate (GFR) is usually expressed in relation to body surface area (BSA) for standardization and comparison between individuals of different sizes, although relating it to extracellular fluid volume (ECV) is technically much simpler because the ratio GFR/ECV is almost equal to the rate constant of the second exponential of the 51Cr-EDTA plasma clearance curve. The aim of this study was to investigate the physiological validity of expressing GFR in relation to ECV by comparing it with GFR normalized for BSA and body weight. METHODS: GFR was measured from a five-sample 51Cr-EDTA plasma clearance curve. After appropriate scaling, the rate constant of the terminal exponential is equal to GFR/ECV. RESULTS: GFR normalized by any of the three variables increased between 0-6 mo, but was less in the case of GFR/weight compared with the other two. From 6 to 24 mo, GFR/BSA continued to increase, whereas GFR/ECV and, in particular, GFR/weight remained relatively constant. It appears that as the child grows to age 6 mo, weight outstrips BSA and ECV but is followed by GFR. From 6 to 24 mo, weight, ECV and GFR increase at a faster rate than BSA. By applying regression analysis to the curves of GFR and its normalization variables versus age, expected (e) and relative (r, i.e., observed/expected) values were obtained for each patient. In the age group 6-24 mo, but not 0-6 mo, r[GFR/ECV] was significantly closer to e[GFR/ECV] than the corresponding comparisons with r and e[GFR/BSA] (p < 0.001) and r and e[GFR/weight] (p < 0.002), supporting the hypothesis that as ECV deviates from the expected value for the patient's age, it tends to be followed by GFR. CONCLUSION: Our data show that ECV is the optimal normalization variable in children, particularly those over the age of 6 mo.

Aging↗
PubMed1977

Measurement of guinea pig body surface area.

The body surface area (BSA) of 50 adult 2/N guinea pigs of both sexes and varying age was measured by the skinning and paper weight technique, or calculated from two equations in which the animals' weight (W) alone or the weight and length (L) were known. The equations BSA = W2/3 x 8.054 and BSA = W0.425 x L0.725 X 3.545 were developed by the method of least squares. The differences between the values obtained by measurement and those obtained by either of the calculation methods were not statistically significant. Differences because of sex and age were also not significant.

Animals↗
PubMed2002

Body surface area and body weight predict total liver volume in Western adults.

Computed tomography (CT) is used increasingly to measure liver volume in patients undergoing evaluation for transplantation or resection. This study is designed to determine a formula predicting total liver volume (TLV) based on body surface area (BSA) or body weight in Western adults. TLV was measured in 292 patients from four Western centers. Liver volumes were calculated from helical computed tomographic scans obtained for conditions unrelated to the hepatobiliary system. BSA was calculated based on height and weight. Each center used a different established method of three-dimensional volume reconstruction. Using regression analysis, measurements were compared, and formulas correlating BSA or body weight to TLV were established. A linear regression formula to estimate TLV based on BSA was obtained: TLV = -794.41 + 1,267.28 x BSA (square meters; r(2) = 0.46; P <.0001). A formula based on patient weight also was derived: TLV = 191.80 + 18.51 x weight (kilograms; r(2) = 0.49; P <.0001). The newly derived TLV formula based on BSA was compared with previously reported formulas. The application of a formula obtained from healthy Japanese individuals underestimated TLV. Two formulas derived from autopsy data for Western populations were similar to the newly derived BSA formula, with a slight overestimation of TLV. In conclusion, hepatic three-dimensional volume reconstruction based on helical CT predicts TLV based on BSA or body weight. The new formulas derived from this correlation should contribute to the estimation of TLV before liver transplantation or major hepatic resection.

Adult↗
PubMed2005

Obesity and dose individualization in cancer chemotherapy: the role of body surface area and body mass index.

It is generally accepted that anti-neoplastic chemotherapy dose should be calculated according to body surface area (BSA). This approach does not account for the presence of obesity. Hence, patients with the same BSA will receive the same chemotherapy dose, regardless the presence of obesity. Since this may cause of toxicity in some obese patients, practice of limit BSA is usual. Currently, the body mass index (BMI) is largely used as a marker of obesity and both BSA and BMI include only height (h) and weight(w) in their formula. We put forward the hypothesis that the BMI should also be taken in account for calculation of chemotherapy dose for obese patients (BMI > 30 kg/m2). In this article, we present a correction to BSA (CBSA) based on the BMI to be tested in obese patients. Our main result is given by the equationCBSA=K(alpha1h(alpha2+2kappa)w(alpha3-kappa)),whereand kappa, alpha1, alpha2, alpha3 are constants. We show examples of how to calculate the CBSA. This simple strategy may limit drug exposition and maintain greater efficacy than a fixed limitation of BSA.

Body Mass Index↗
PubMed2001

The natural history of the growth of the hand: I. Hand area as a percentage of body surface area.

The use of a patient's own hand as a tool to estimate the area of burn injury is well documented. The area of the palmar surface of one hand has been estimated to be 1 percent of the body surface area. The area of the palmar surface of the hand was measured to test the accuracy of this estimate and then compared with the body surface area as calculated by formulas in common use. This study also sought to determine the natural history of the growth of the hand to permit development of a readily available, bedside means of estimating hand area and body surface area. Bilateral hand tracings were obtained from 800 volunteers ranging in age from 2 to 89 years. The area of each tracing was determined using an integrating planimeter. The height and weight of each individual were measured, and his/her body surface area was calculated. The palmar hand's percentage of body surface area was determined by calculating the quotient for hand area divided by body surface area. Additionally, the width of the hand was measured from the ulnar aspect at the palmar digital crease of the small finger to the point where the thumb rested against the base of the index finger. The length of the hand was measured from the middle of the interstylon to the tip of the middle finger. These two figures were multiplied together to obtain a product which approximated the area of the hand. Based on the most commonly used DuBois formula for calculating body surface area, the area of palmar surface of the hand corresponds to 0.78 +/- 0.08 percent of the body surface area in adults. The percentage varies somewhat with age and reaches a maximum of 0.87 +/- 0.06 percent in young children. Multiplying the length of the hand by its width overestimates the area of the hand as determined by planimetry by only 2 percent. A patient's own hand may be used as a complementary, readily available template for estimation of burn area or other areas of disease or injury. In adults, the area of tracing of the outline of the hand is 0.78 percent of the body surface area, whereas in children, this number tends to be slightly higher. In the emergency room or on the wards, a simple product of length multiplied by width of the hand will closely approximate the area as determined by planimetry. This method allows a more accurate determination of the area of the palmar surface of the hand than the 1 percent estimate, which may lead to an overestimation of the size of a burn wound in adults.

Adolescent↗
PubMed2003

The importance of metabolic rate and the folly of body surface area calculations.

Mathematical formulae to calculate body surface area from measurements of height, weight and other parameters date from the late 19th century. Drug doses, fluid therapy, caloric requirements and physiological parameters such as cardiac output, glomerular filtration rate and a variety of respiratory function parameters are all frequently expressed in terms of a body surface area. Body surface area is often used in preference to body mass (weight). However, the original rationale for using body surface area as an estimate for metabolic rate has never been tested and the algorithms used to approximate body surface area have little evidence to support their use in this role. Recent developments in technology using indirect calorimetry allow easy measurement of metabolic rate in the clinical setting. Such measurements should be used for standardisation when weight alone is considered inadequate.

Anthropometry↗
PubMed2002

Investigation into the relationship between body surface area and total body potassium using Monte Carlo and measurement.

The use of body surface area (BSA) as a means of indexing chemotherapy doses is widespread even though the value of this practice is uncertain. In principle, the body cell mass (BCM) more closely represents the body's metabolic size and this is investigated here as an alternative to BSA; since 98% of body potassium is intracellular the derivation of total body potassium (TBK) via the measurement of 40K in a whole body counter (WBC) will provide a useful normalizing index for metabolic size, potentially avoiding toxicity and underdosing. The Queen Elizabeth Hospital WBC has been used in this study, initially involving single geometrical phantoms and then combinations of these to simulate human body habitus. Monte Carlo N-particle (MCNP) codes were constructed to model the phantoms and simulate the measurements made in the WBC. Efficiency corrections were derived by comparing measurement and modelled data for each detector separately. A method of modelling a person in the WBC as a series of ellipsoids was developed. Twenty-four normal males and 24 females were measured for their 40K emissions. Individual MCNP codes were constructed for each volunteer and the results used in conjunction with the measurements to derive TBK, correcting for body habitus effects and detector efficiencies. An estimate of the component of error arising from sources other than counting statistics was included by analysing data from the measurement of phantoms. The total residual errors (expressed as coefficients of variation) for males and females were 10.1% and 8.5% respectively. The measurement components were determined to be 2.4% and 2.5%, implying that the biological components were 9.8% and 8.1% respectively. These results suggest that the use of BSA for indexing chemotherapy doses is likely to give rise to clinically significant under- or overdosing.

Body Surface Area↗
PubMed2006

Effect of body surface area calculations on body fat estimates in non-obese and obese subjects.

The purpose of the present study was to compare body surface area (BSA) estimates using two equations (Dubois and Dubois versus Livingston) and their respective effects on per cent body fat (%BF) obtained with two molecular approaches of body composition analysis, two-compartment (2C) and five-compartment (5C) models. Body composition data using the 2C model were studied in healthy adults, 432 women (body mass index (BMI): 28.3 +/- 4.4 kg m(-2)) and 147 men (BMI: 26.8 +/- 3.9 kg m(-2)), while another sample of 126 women (BMI: 30.4 +/- 3.7 kg m(-2)) was evaluated using the 5C model. Measures of body volume (BV) assessed by air displacement plethysmography, bone mineral content by dual energy x-ray absorptiometry (DXA) and total-body water by deuterium dilution were used to estimate %BF with the 5C model. Comparison of means and linear regression analysis was performed. Using BSA(Dubois), either in 2C and 5C models, BV and %BF estimates were significantly underestimated compared to results obtained using BSA(Livingston) (p < 0.05). BMI was strongly associated with %BF differences using BSA(Dubois) and BSA(Livingston) in both 2C (men: r = 0.90; women: r = 0.88) and 5C models (r = 0.88). Though %BF(Dubois) and %BF(Livingston) were strongly associated (r(2) = 1.000), some variability was observed on %BF differences using BSA(Dubois) and BSA(Livingston). These findings suggest that BSA calculation is critical in BF estimation, supporting the use of a more accurate equation for non-obese and obese subjects.

Adipose Tissue↗
PubMed1979

Determination of body surface area in neonatal swine.

The body surface area of 30 neonatal pigs of both sexes, weighing 445--1,976 g, were determined by the direct skinning technique. The range of measured body surface area values was 635--1,400 cm2 (mean = 895.1 cm2). The regression line, fitted to a scatter diagram and calculated by the least square method, was found to be Y = 337.2 + 0.553X; where X was body weight expressed in grams and Y was body surface area expressed in square centimeters.

Animals↗
PubMed1993

Indirect measurement for body surface area of cotton rats.

The body surface areas (BSAs) of 42 cotton rats (21 females weighing 29.08 to 169.60 g, and 21 males weighing 18.93 to 168.03 g) were measured. From these areas and body weights (BW), the equation, BSA (cm2) = 47.66 + 2.476 x BW (g) -0.006 x BW (g)2, was derived. To verify the applicability of the equation, the BSAs of another 19 animals (12 females weighing 29.08 to 169.60 g, and 7 males weighing 19.27 to 167.32 g) were calculated and the values compared with the measured BSAs. The correlation between calculated and measured BSAs was significant (r = 0.995, P < 0.01). Therefore, this equation can be used to calculate cotton rat BSA.

Animals↗
PubMed1996

Dependency of standardized uptake values of fluorine-18 fluorodeoxyglucose on body size: comparison of body surface area correction and lean body mass correction.

In an attempt to minimize dependency of conventional standardized uptake values (SUVs) of F-18-fluorodeoxyglucose (FDG) normalized for the total body weight (TBW) on patient's body weight, the uses of SUV corrected for the lean body mass (LBM) and that corrected for the body surface area (BSA) have been proposed as alternatives. We compared the dependency of SUVLBM and SUVBSA on the overall body size. FDG-PET images were acquired on 44 patients. SUVLBM and SUVBSA for the liver were determined as previously described. Following normalization of the scales of the values obtained from these two approaches, the mean +/- S.D. was 2.86 +/- 0.52 (SUVLBM) and 2.86 +/- 0.50 (SUVBSA). A linear regression analysis was performed for correlating the liver SUVLBM and SUVBSA, with each of TBW, LBM, BSA and height. The dependency of the two values on TBW was similar. SUVLBM showed a moderate dependency on height (r = 0.56, P = 0.00007), LBM (r = 0.55, P = 0.0001) and BSA (r = 0.51, P = 0.0004), whereas SUVBSA showed no dependency on LBM (r = 0.18, P = 0.24) or height (r = 0.20, P = 0.19), and a minimal dependency on BSA (r = 0.38, P = 0.01). In conclusion, SUVBSA appears to be less dependent on overall body size, particularly height and lean body mass, than SUVLBM.

Abdominal Neoplasms↗
PubMed2000

Percentage of burned body surface area determination in obese and nonobese patients.

BACKGROUND: The measurement of burn surface area is important during the initial management of burn patients for estimating fluid requirements and determining hospital admission criteria. The "rule of nines" is commonly used for this purpose. However, the proportional contribution of various major body segments to the total body surface area changes with obesity. Similarly infants have very large heads, altering the overall contribution of other body segments to the total body surface area. METHODS: Detailed body surface area measurements were made in 47 patients: 18 were of normal weight, 6 were moderately obese, and 23 were seriously obese. Published tables of similar measurements for infants were reviewed to determine how the rule of nines applied to these populations. The contribution of the major body segments to the overall body surface area was calculated and compared to estimates that would be derived for these segments from the rule of nines. RESULTS: The rule of nines provides reasonable estimates of body surface area for patients ranging from 10 to 80 kg. For obese patients weighing more than 80 kg a rule of fives is proposed: 5% body surface area for each arm, 5 x 4 or 20% for each leg, 10 x 5 or 50% for the trunk, and 2% for the head. For infants weighing less than 10 kg a rule of eights applies: 8% for each arm, 8 x 2 or 16% for each leg, 8 x 4 or 32% for the trunk, and 20% for the head. CONCLUSION: Various body parts differentially contribute to the total body surface area. Because these relationships remain relatively constant throughout growth, the rule of nines provides reasonable estimates for the determination of burned body surface area for most children and adults. These relationships break down for infants and obese adults and the proposed modifications to the rule of nines provide better estimates of surface area for these groups.

Adult↗
PubMed1999

[Study of formula for calculating body surface areas of the Chinese adults].

The body surface area of 100 Chinese adults (50 for each sex) was measured with the paper cast method and compared to the results estimated by the Stevenson's "height-weight-surface" formula. Our results shows that Stevenson's formula is no longer suitable for the Chinese. Our formulae for Chinese are as follows: SI=0.0061 x H + 0.0124 x W - 0.0099 (for both sexes), SII=0.0057 x H + 0.0121 - W + 0.0882 (for male), SIII=0.0073 H + 0.0127 x W - 0.2106 (for female) H: body height, W: body weight, S: body surface area

Adult↗
PubMed1975

Body surface area in the infant rat.

Body surface area (SA), one index used to minimize size differences in metabolic studies, was estimated by a coating method in rats aged 1, 7, 14, and 21 days (d) (n = 100-107). Body weights (BW) at each age varied about twofold. Regression equations were calculated for SA (cm2) vs. BW (g) (SA = 8.73 + 2.29 BW, 17.79 + 1.71 BW, -4.92 + 2.16 BW, and 53.68 + .82 BW at 1, 7, 14, and 21 days, respectively) and log SA vs. log BW (SA = 6.71 BW0-667, 9.12 BW0-577, 1.73 BW1-042, and 18.97 BW0-412). All the latter differed significantly from SA = 10 BE2/3, frequently used with adult mammals. Correlation coefficients were approximately 0.6-0.9 and did not differ with mode of expressing results. Regressions, whether linear or logarithmic, differed significantly among ages, apparently reflecting appreciable conformational changes in the rapidly growing and maturing preweanling rat.

Age Factors↗
PubMed1976

Determination of body surface area in the rhesus monkey.

Body surface areas (BSA) of 31 apparently normal rhesus monkeys of both sexes weighing 3.2-5.3 kg were determined by the direct skinning technique. The range of measured BSA was 1,940-3,020 cm2 (mean = 2,430 cm2). The BSA values of male and female monkeys were not significantly different. The K value, calculated as the ratio of BSA (cm2)/body wt2/3 (kg), was 969 +/- 15 (SE). Based on the principle of least squares for goodness of fit between the measured and calculated BSA, the best equation was determined to be (see article). A nomogram was constructed for rapid determination of the BSA of rhesus monkeys with known body weight and lengths (head to anus). Monkey BSA could also be computed by multiplying the DuBois human BSA equation by a factor of 1.147 for the head-to-anus measure of length or by 0.891 for the head-to-heel measurement.

Animals↗
PubMed2003

A formula for the estimation of the body surface area of Saudi male adults.

OBJECTIVE: Human body surface area (BSA) is the preferred denominator for physiological indices of body metabolism and for drug dosages. The Du Bois and Du Bois height/weight nomogram, used for fast and convenient estimation of patients BSA, is not suitable for all populations due to ethnic differences in body shape and build. The purpose of this study was to obtain direct measurements of BSA and use the data to construct a prediction formula for Saudi male adults. METHODS: Body surface area was measured in 21 adult male Saudis at Assir Central Hospital in Abha, Kingdom of Saudi Arabia between 2000 and 2003, using a coating technique. Areas of the coating material were determined with a compensating planimeter. Other anthropometric indices were measured or calculated according to standard procedures. Measured values of BSA were subjected to linear regression analysis using the least squares method to obtain a formula for predicting BSA from heights and weights. RESULTS: Mean body mass index (BMI) was 25.1 +/- 1.6 kg/m2; linearity, 2.46 +/- 0.13 cm/kg; surface to mass ratio, 0.025 +/- 0.0008 m2/kg; relative sitting height (RSH), 0.51 +/- 0.005. The closest fit to measured BSA values was given by the biexponential regression equation: BSA=0.02036 x H(0.516) x W(0.427) +/- 0.01283. This formula predicts BSA of Saudi male adults more accurately than all existing equations tested and yields a convenient BSA table for Saudis. CONCLUSION: The use of our formula, with prediction accuracy superior to those of existing formulae, should facilitate the establishment of normal values of other physiological indices. It should also lead to more reliable and precise drug dosages and expedite rapid decision making in critical care situations.

Adult↗