Validation of Advanced Paediatric Life Support Formulas for Weight Calculation in a Multiethnic Population

Introduction. The aims of this study were to validate the new formulas for weight calculation introduced by the advanced life support group (alsg) of the United Kingdom in 2011 and compare their performance to the formula currently used by the European Resuscitation Council (ERC) and other formulas and to check whether performance of formulas for weight calculation is affected by ethnic group and gender. Methods. Prospective audit of weight versus calculated weight comparing alsg formula with ERC, Luscombe, Argall, and Best Guess formulas analysed for gender, age, and ethnic groups. Results. Prospectively 599 children were included: 157 Asian, 268 Caucasian, and 174 children from other origin. In infants there was no difference between actual weight and alsg formula calculated weight. There was a progressively increased underestimation of weight year by year from 1 to 10 years of age using the ERC formula. In the 6–10 year age group the ERC formula underestimated the weight by a mean of 6.5 kg (21.8%, ) with the alsg and Luscombe formulas performing best. In 11-12 year old children the alsg formula estimated well. Conclusion. In one- to ten-year-old children, the Luscombe formula provided a better weight estimate than alsg and ERC formulas in a multiethnic population. 1. Introduction In a life threatening emergency, rapid establishment of a patient's weight is required to enable calculation of drug doses, amount of fluid to be administered to correct hypovolemic shock, and amount of electricity to be applied in ventricular fibrillation and other arrhythmias. In most cases a present weight is not known and the patient cannot be weighed because of ongoing procedures required for resuscitation, trauma requiring immobilization, and risk of exacerbation of pain. Formulas are therefore used to calculate weight rapidly from age. It is essential to establish which formula is most appropriate in any population at a given time before its application in an emergency. Childhood obesity has been increasing over the years [1, 2] and requires regular appraisal of the appropriateness of formulas for calculation of weight from age. The child heart and health study in England (CHASE study) has found differences in adiposity levels in different ethnic groups with South Asian children having higher obesity levels compared with Caucasian children [3]. In an Asian population in Karnataka, India, the formula used by the European Resuscitation Council (ERC formula, former APLS formula) overestimated the weight by at least 2-3？kg in children one to twelve years of age [4]. In a