178 - A Study to Validate the PAWPER XL Tape in Estimating The Body Weight of Children and Comparison With BROSELOW Tape of Weight Estimation

Poster Number: 178
Publication Number: 178.317

Pooja S. Wali, Imperial college of London centered at KIMS hubli, Hubli-Dharwad, Karnataka, India; anil shetty, Father Muller Medical College, Mangalore, Karnataka, India

Background: Weight estimation is part of the management of critically ill children, as drug dosing and several interventions are weight based. Thus weight estimation systems should be accurate, the age based (one dimensional) methods are found less accurate. Two-dimensional method (PAWPER-XL/MAC) system should be considered.

Objective: To determine accuracy of PAWPER XL tape in estimating total and ideal body weight of children and comparison with BROSELOW tape of weight estimation.

Design/Methods: We conducted a prospective study recruiting 1000 children aged 1month-10 years attending to pediatric inpatient, outpatient and emergency department of Father Muller hospital between October 2018 to September 2020. Anthropometric measures like weight, MAC(Mid Arm Circumference), Habitus were assessed. Weight's estimated by Broselow, PAWPER-XL and PAWPER-MAC method and accuracy assessed. Statistical analysis done using MPE and McNemar/Fischer Exact test and graphically represented using modified Bland-Altman plot.

Results: The percentage of TBW estimates were within 10% and 20% of actual weight (PW10 and PW20) for the Broselow, PAWPER XL tape, PAWPER-MAC was 35.4%, 65.3%, 76.2% and 92.9%, 99.1%, 98.9% respectively (table 1).
Mean values of weight estimated in ( < 10kg, 11-25kg) of subjects by Broselow, P-XL, P-MAC method is statistically significant with a p value of < 0.001. Mean values, mean difference and p-value in weight group >25kg estimated by Broselow is 31.75, 1.0929 and 0.026 respectively is statistically significant, whereas mean values of P-XL, P-MAC methods being 32.01, 31.8 respectively with lower mean difference of 0.175 and 0.38 respectively are statistically insignificant with a p value of 0.561and 0.125.
Modified Bland & Altman plots depicted that accuracy of weight estimation method is in this order P-MAC > P-XL > Broselow(figure 1).
 Conclusion(s): The PAWPER XL/MAC system were more accurate than Broselow system. Accuracy was more than the original PAWPER tape because of its expanded length and modified habitus score categories. PAWPER XL and MAC tape were more precise in obese children category too. The PAWPER-MAC method showed statistical significance in measuring IBW over PAWPER-XL and Broselow. The Accuracy of the three systems studied is in this order PAWPER-MAC >PAWPER-XL >Broselow system.
 
 
Modified Bland & Altman plot for Broselow, PAWPER-XL and PAWPER-MAC tapeModified Bland & Altman plots depicted that accuracy of weight estimation method is in this order P-MAC > P-XL > Broselow
Outcomes of the weight estimation systems against total body weight(TBW)The percentage of TBW estimates were within 10% and 20% of actual weight (PW10 and PW20) were in this order Broselow < PAWPER XL tape < PAWPER-MAC. PAWPER-MAC was most accurate of three with less error rate.