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PubMedDate not supplied

Body surface area as a parameter of age decline.

We determined the age loss of body surface area (DuBois) in a cross-sectional and longitudinal combined study of 209 men and women aged between 40 and 96 from a rural region in the northwest of Spain. We established a secular growth trend of 1.01 +/- 0.30 mm per year, observable in this region since 1880, in 424 men joining the army between 1850 and 1970. Even after consideration of this growth trend, the loss of body surface area was shown to be strongly associated with age in adults of both sexes, with up to 2.5% loss per year in the oldest participants. Similarly the loss of body height becomes an individually dramatic process, in the sense that proportions of the body are no longer preserved. The secular growth trend in this region started long before the improvement of living conditions, commonly cited as causally involved in acceleration processes.

Journal Article↗
PubMed1988

Unexpected toxicity associated with use of body surface area for dosing melphalan in the dog.

A multiinstitutional Phase I study using i.v. melphalan was conducted in dogs with spontaneously occurring neoplasia. Melphalan was administered at 7.5, 10, 11.25, 12.5, and 20 mg/m2 of body surface area. Disproportionately greater toxicity was observed in small dogs. Seven of the eight dogs (88%) weighing less than 14 kg experienced severe myelosuppression (neutropenia, less than 1500/mm3; and/or thrombocytopenia, less than 80,000/mm3), whereas only three of 13 dogs (23%) weighing greater than 14 kg developed severe myelosuppression (P = 0.016). We concluded that small dogs are at greater risk of developing bone marrow toxicity from i.v. melphalan than large dogs if body surface area is used to calculate the dose. Although both body surface area and weight were found to be significantly correlated with severity of toxicity, melphalan-induced toxicity in dogs can be more accurately estimated by body weight than by surface area, P = 0.008 versus P = 0.022, respectively. It may be necessary to prescribe antineoplastic agents that are eliminated by processes not primarily under metabolic influence or that produce side effects on tissue not correlated to basal metabolic rate on a parameter other than body surface area. In dogs, melphalan should be dosed on a weight basis, and treatment groups should be stratified by weight in randomized clinical studies, particularly when the weight range of treated subjects is great.

Animals↗
PubMed2000

Inter- and intrapatient variability in oral topotecan pharmacokinetics: implications for body-surface area dosage regimens.

Anticancer drugs still are dosed based on the body-surface area (BSA) of the individual patient, although the BSA is not the main predictor of the clearance for the majority of drugs. The relevance of BSA-based dosing has not been evaluated for topotecan yet. A retrospective pharmacological analysis was performed of kinetic data from four clinical Phase I studies in which topotecan was administered p.o. as a single agent combined with data from a combination study of topotecan and cisplatin. A strong correlation (r = 0.91) was found between the area under the plasma concentration time curve of the lactone and carboxylate forms of topotecan by plotting 326 data sets obtained from 112 patients receiving oral topotecan at dose levels ranging from 0.15-2.70 mg/m2. The intrapatient variability, studied in 47 patients sampled for 3 or more days, for the apparent lactone clearance, ranged from 7.4-69% (mean, 24 +/- 13%; median, 20%). The interpatient variabilities in the lactone clearance, calculated with the data of all studied patients, expressed in liter/h/m2 and in liter/h were 38% and 42%, respectively. In view of the relatively high inter- and intrapatient variabilities in topotecan clearance, in contrast to a variability of only 12% in the BSA of the studied patients, no advantage of BSA-based dosing was found over fixed dose regimens.

Administration, Oral↗
PubMed2004

A computer program for calculation of doses and prices of injectable medications based on body weight or body surface area.

A computer program (CalcAnesth) was developed with Visual Basic for the purpose of calculating the doses and prices of injectable medications on the basis of body weight or body surface area. The drug names, concentrations, and prices are loaded from a drug database. This database is a simple text file, that the user can easily create or modify. The animal names and body weights can be loaded from a similar database. After typing the dose and the units into the user interface, the results will be automatically displayed. The program is able to open and save anesthetic protocols, and export or print the results. This CalcAnesth program can be useful in clinical veterinary anesthesiology and research. The rationale for dosing on the basis of body surface area is also discussed in this article.

Animals↗
PubMed2000

Body surface area as a predictor of aortic and pulmonary valve diameter.

BACKGROUND: Predicting cardiac valve size from noncardiac anatomic measurements would benefit pediatric cardiologists, adult cardiologists, and cardiac surgeons in a number of decision-making situations. Previous studies correlating valve size with body size have been generated with the use of fixed autopsy specimens, angiography, and echocardiography, but primarily in the young. This study examines the relation of body surface area to measurements of the left ventricular-aortic junction (aortic valve anulus diameter) and the right ventricular-pulmonary trunk junction (pulmonary valve anulus diameter) in 6801 hearts across a wide spectrum of ages. METHODS: From June 1985 to October 1998, cardiac valves from 6801 donated hearts were analyzed morphologically. Donor age was newborn to 59 years (mean 31 +/- 17 years; median 32 years). Calculated body surface areas ranged from 0.18 to 3.55 m(2). Aortic (n = 4636) and pulmonary valve diameters (n = 5480) were measured from enucleated valves suitable for allograft transplantation. Mean valve sizes were computed for ranges in body surface area in 0.1-m(2) increments. RESULTS: For adult men (age >/= 17 years), the mean aortic valve diameter was 23.1 +/- 2.0 mm (n = 2214) and the mean pulmonary valve diameter was 26.2 +/- 2.3 mm (n = 2589). For adult women, the mean aortic valve diameter was 21.0 +/- 1.8 mm (n = 1156) and the mean pulmonary valve diameter was 23.9 +/- 2.2 mm (n = 1408). The mean indexed aortic valve area was 2.02 +/- 0.52 cm(2)/m(2) and the pulmonary valve area 2.65 +/- 0.52 cm(2)/m(2). Between 82% and 85% of the variability was explained by the size of the patient. Regression equations were developed both overall and separately for men and women, although the additional contribution of sex above that of body size was less than 1%. CONCLUSIONS: Aortic and pulmonary valve diameters are closely related to body size. Thus, body surface area, when used in conjunction with other clinically accepted evaluations, is a useful tool for estimating normal aortic and pulmonary valve size.

Adolescent↗
PubMed2000

Body surface area: Du Bois and Du Bois revisited.

The Du Bois and Du Bois body surface area (BSA) equation is used widely to normalise physiological parameters. However, that only nine subjects were used in its derivation does not appear to be well known and does not justify its ubiquitous application. Furthermore, the derivation appears to be hampered by a lack of modern statistical methods and the omission of a large amount of available data. We have shown that the omitted data, obtained by measurement of the length of body parts, were identical to the data obtained by encasing subjects in moulds ¿BSA (moulds; cm2) = [1.00 (0.02)] x BSA (linear measurements) + [123 (347)]¿. Non-linear regression analysis of the BSA of all 42 subjects reported by Du Bois and Du Bois gave new values for the constants of the model ¿BSA (cm2) = 94.9 x [weight (kg)0.441] x [height (cm)0.655]¿. Although the original equation obtained by Du Bois and Du Bois was found to be adequate in adults, we recommend that it should not be used in daily practice, owing to the low number of subjects used in its derivation. The work presented here has placed the original results of Du Bois and Du Bois on a more robust statistical footing, yielding values for the model constants that would have been obtained if Du Bois and Du Bois had had access to modern statistical methods.

Adult↗
PubMedDate not supplied

Body surface area limitations in achieving adequate therapy in peritoneal dialysis patients.

OBJECTIVE: To estimate the maximal body surface area (BSA) at which anuric chronic peritoneal dialysis patients can achieve adequate peritoneal dialysis using a variety of continuous ambulatory peritoneal dialysis (CAPD) and cycler regimens. Adequate dialysis was defined as a creatinine clearance of either 60 L/week/1.73 m2 or 70 L/ week/1.73 m2. DESIGN: Calculation of daily peritoneal creatinine clearances using standard formulas. For CAPD patients, creatinine clearance was calculated using published values for dialysate-to-plasma ratios for creatinine (D/P cr) measured over a 24-hour period and assuming a daily ultrafiltration rate of 1.5 to 2.0 L/day. For cycler patients, creatinine clearance was calculated for both one- and two-hour dwell volumes, using published values for D/P cr from the peritoneal equilibration test and assuming a daily ultrafiltration rate of 2.0 L/day. All clearances were corrected to a normalized body surface area of 1.73 m2. RESULTS: For CAPD patients, 2-L dwell volumes can provide a weekly creatinine clearance of 60 L/week/1.73 m2 in patients with BSA < 1.45 m2 in the high transporter group and with BSA < 1.2 m2 in the low-average transporter group. Increasing dwell volume from 2.0 to 2.5 L increases these BSA limits in the four transport groups by 0.2-0.3 m2. Cycler therapy is not a viable option for patients in the low transporter group, and this therapy can achieve adequate creatinine clearances in patients in the low-average transport group only with large dwell volumes and in patients with BSA < 1.55 m2. However, in the high-average and high transporter groups, cycler therapy provides for superior creatinine clearances compared to CAPD patients using similar dwell volumes. CONCLUSIONS: Adequate creatinine clearances in anuric patients are most likely to be achieved in patients with BSA > 2.0 m2 if they have high-average or high transport characteristics and are receiving cycler therapy with large dwell volumes and at least one daytime dwell. However, adequate creatinine clearances may be difficult to achieve in anuric patients who have a large BSA and a low or low-average transport type, regardless of peritoneal dialysis modality. These patients should be considered for either high-dose peritoneal dialysis (multiple daytime and nighttime exchanges) or hemodialysis therapy.

Body Surface Area↗
PubMed1991

Body surface area, a reference for space allowance in confinement.

One of the most important welfare concerns in relationship to poultry production is the restriction, both physical and social, imposed by close and long-lasting confinement. The bird's body-surface area was considered as a reference base for the determination of a minimum space allowance in the present study. The formula for surface area was based on body weight, which is a well-known and easily measured parameter. As the bird grows, its surface area changes in proportion to its weight gain, and, therefore, surface area provides a continuous estimate of the space requirement. The floor space allowance can be easily visualized from body surface area and estimated without extensive measurements of birds and floor areas. It is recommended that the minimum space requirement for poultry should be no less than the equivalent of 50% of the bird's body surface area. This recommendation was based on the principle that all birds in an enclosure should be able to rest simultaneously without contacting another bird or the walls of the enclosure.

Animals↗
PubMed2006

Normalization in quantitative [18F]FDG PET imaging: the 'body surface area' may be a volume.

Non-invasive methods for quantifying [(18)F]FDG uptake in tumours often require normalization to either body weight or body surface area (BSA), as a surrogate for [(18)F]FDG distribution volume (DV). Whereas three dimensions are involved in DV and weight (assuming that weight is proportional to volume), only two dimensions are obviously involved in BSA. However, a fractal geometry interpretation, related to an allometric scaling, suggests that the so-called 'body surface area' may stand for DV.

Biophysical Phenomena↗
PubMed1985

A revision of body surface area estimations.

The results from the present study indicate that the equation of Dubois and Dubois (1916), now in common use for estimating body surface area, is not the most accurate of those available. Our new equation is based on the measurement of body weight and upper calf circumference only. It accounts for a large percentage of the total variance (88.9%), and has a low standard error of estimate (0.05 m2), which suggests that this equation may be more useful in the estimation of human body surface area than many of the equations previously produced. Direct comparisons of the accuracy of other workers' equations is difficult to assess due to the different methods by which the equations have been produced and expressed. We do not advocate the use of different equations for males and females because the data indicate that the present equation probably applies equally well to both sexes.

Adolescent↗
PubMed1978

Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults.

Estimates of body surface area were made based on measurement of 81 subjects, ranging from premature infants to adults. SA was calculated geometrically for each subject from 34 body measurements, and the values obtained compared with those based on previously published formulas and graphs. The most widely used formula, that of Du Bois and Du Bois, increasingly underestimated SA as values fell below 0.7 m2; the disparity was greatest in the newborn infant (7.96%). Closer agreement was obtained with the equations and nomograms of Body, Brody, Faber and Melcher, and Sendroy and Cecchini, although minor deviations were noted in some age ranges. The formula SA (m2) = weight (kg)0.5378 X height (cm)0.3964 X 0.024265, derived from the measured data by multiple regression analysis, gave a good fit for all values of SA from less than 0.2 m2 to greater than 2.0 m2 (r = 0.998). This formula was used to construct nomograms for estimation of SA in infants, children, and adults from height (length) and weight.

Adult↗
PubMed1994

Age and body surface area related normal upper and lower limits of M mode echocardiographic measurements and left ventricular volume and mass from infancy to early adulthood.

BACKGROUND: M Mode echocardiograms can be measured by two different conventions. In addition, normal limits of echocardiographic measurements have customarily been stratified according to age or body surface area. There is therefore a need to develop a more easily managed approach to calculating normal limits of measurements for the two conventions, one of which, the Penn convention, has not previously been used for echocardiographic measurements in children. METHODS: M mode echocardiograms were recorded in 127 healthy subjects aged from 7 months to 19.5 years. Measurements were made from paper recordings according to the recommendations of the American Society of Echocardiographers and those of the Penn convention. RESULTS: Age and body surface area were found to be highly correlated; but for completeness separate age dependent and body surface area dependent equations for the normal limits of M mode echocardiographic variables were developed. CONCLUSION: A set of age dependent equations and a set of body surface area dependent equations are presented for easy calculation of upper and lower limits of normal M mode echocardiographic variables in infants and children.

Adolescent↗
PubMed1993

Cutaneous malignant melanoma: association with height, weight and body-surface area. a prospective study in Norway.

To investigate whether anthropometric indices as body height, body-mass index (BMI) and body-surface area (BSA) have any influence on the risk of cutaneous malignant melanoma (CMM), we analyzed height and weight data from a Norwegian screening survey running between 1963 and 1975 and comprising 1.3 million individuals followed for 14 to 26 years. Among females, CMM was diagnosed in 2814 incident cases, while the number among males was 2144 during 22,988,345 person-years of follow-up. With adjustment for age, birth cohort, geographic region and BMI, the risk for CMM increased significantly with increasing quintiles of height in both sexes. The tallest persons were at greater relative risk than the shortest ones: 1.60 and 1.59 in males and females respectively. This positive association was also found for CMM localized on face and trunk in both sexes, and in the lower limbs only in females. Males in the highest quintile of BMI had a relative risk for CMM of 1.26 compared with the lowest quintile, while a non-significant negative association were found in obese females. This negative association increased and was significant for CMM located on the trunk and lower limbs in females. Among males we observed a consistent association between BSA and risk of CMM similar to that for height. These relationships between anthropometric indices and CMM are discussed according to factors which promote growth, among which nutrition, social class and hormones are the most important.

Adolescent↗
PubMed2001

Body surface area estimation in children using weight alone: application in paediatric oncology.

The majority of chemotherapy regimens and trials specify doses of cytotoxic drugs normalized to body surface area. Estimation of BSA in paediatric patients is particularly problematic, as conventional nomograms require accurate determination of both height and weight. The chemotherapy standards group of the UKCCSG (United Kingdom Children's Cancer Study Group) has evaluated a method for calculation of body surface area (BSA) estimation, based solely on patient weight. In comparison with BSA estimations using 2 commonly used methods, which require both weight and height measurements, deviation in the estimate of BSA was less than 10%. This method may be extended to the dosing of chemotherapeutic agents in infants of body weight less than 10 kg, with appropriate recommendations for dose modification. Until better correlates of drug clearance, such as GFR for carboplatin, are identified BSA is used to standardize doses for most chemotherapeutic agents. The formula presented here provides a more robust and reliable method of calculation of BSA from weight alone. Although this approach has been shown to be equivalent to other currently used methods, care should be taken extending this calculation of BSA to children less than 10 kg, to obese patients and to those with cachexia.

Algorithms↗