Indexed hemodynamic measurements may be inappropriate at body surface area extremes

Excerpt

As the epidemic of obesity and morbid obesity [1] spreads and as more obese patients require intensive care, it is important to use appropriately body surface area (BSA) indexed hemodynamic measurements [2]. The idea of adjusting for variation in heights and weights while making comparisons was first described by DuBois and Dubois in 1916. Unfortunately, they derived their widely used formula based on only nine patients, none of whom were morbidly obese. Since then, multiple formulae have been proposed based on larger sample sizes, including those by Mosteller, Haycock, Gehan and George, Boyd, Fujimoto, and Livingston [3]. Only Livingston and colleagues made an explicit effort to include obese patients when deriving a BSA formula. …