How reliable is length-based determination of body weight and tracheal tube size in the paediatric age group? The Broselow tape reconsidered.

BACKGROUND: The Broselow tape was designed to estimate body weight and tracheal tube size on the basis of the body length of emergency paediatric patients. The tape was validated previously in US populations. We assessed its accuracy in a sample of European children by reviewing paediatric anaesthetic charts at the Triemli City Hospital for 1999.

METHODS: Age, body length and body weight measured before surgery as well as the size of the tracheal tube used were recorded. The body weight was estimated on the basis of body length using the Broselow tape and was compared with the measured weight. Tracheal tube size selections using the Broselow tape and an age-based formula were compared with the size of the tube used.

RESULTS: A good correlation was found between the Broselow weight and the measured weight (r2=0.88). Bland-Altman analysis revealed a mean bias of -0.52 kg for the entire study population. For children < or = 20 kg the mean bias was -0.05 kg, and for children > 20 kg was -1.05 kg. The Broselow weight was found to be within a 10% error of the measured weight in 65% of children. Tracheal tube selection by the Broselow tape method was adequate in 55% but underestimated the actual tube size in 39%. The age-based formula matched the actual tracheal tube size in 41% of children but overestimated it in 57%.

CONCLUSIONS: The Broselow tape is an accurate means to assess body weight from length in smaller children; in older children it underestimated body weight. Endotracheal tube size selection by the Broselow tape appears to match the size of the tube used better than the age-based formula. The results in a European sample of children are comparable to the US data.