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Highly Accessed Open Badges Letter

Misleading indexed hemodynamic parameters: the clinical importance of discordant BMI and BSA at extremes of weight

Adam C Adler12*, Brian H Nathanson3, Karthik Raghunathan4 and William T McGee25

Author Affiliations

1 Department of Anesthesiology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA

2 Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA

3 OptiStatim, LLC, P.O. Box 60844, Longmeadow, MA 01116, USA

4 Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA

5 Department of Medicine and Surgery, Division of Critical Care, Baystate Medical Center, 759 Chestnut Street, Springfield MA 01199, USA

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Critical Care 2012, 16:471  doi:10.1186/cc11876

Published: 28 December 2012

First paragraph (this article has no abstract)

The widespread availability of minimally invasive hemodynamic monitors encourages evaluation of cardiac output (CO) and stroke volume (SV) in real time, and they are integral to goal-directed therapy, algorithm-based treatment plans. Patients with extremes of body surface area (BSA) are at risk of having their indices erroneously evaluated despite adequate non-indexed values. We evaluated the use of body mass index (BMI) in this population and identified a discordance of BSA and BMI values at extreme weights. We recommend unindexed values in these patients when deciding treatment options.