Review of commonly used age‐based weight estimates for paediatric drug dosing in relation to the pharmacokinetic properties of resuscitation drugs

AIM:

To study which weight estimate calculation used in paediatric resuscitation results in optimal drug dosing; Advanced Paediatric and Life Support (APLS) or the UK Resuscitation Council age‐based formula.

Method

Commonly used drugs used in paediatric resuscitation were selected and a literature search conducted for each drug's pharmacokinetic properties, concentrating on the volume of distribution (Vd).

Results

The new APLS formulae give higher estimates of expected weight for a wider age range. This may be a more accurate reflection of ABW due to increasing prevalence of obesity in children. The UK Resuscitation Council's formula appears to result in a lower estimate of weight, which may relate more closely to IBW.

Conclusion

The main drugs used in paediatric resuscitation are hydrophilic, thus the APLS formulae may result in too much being given. Therefore the UK Resuscitation Council's single formula may be preferred. In addition, a single formula may minimize error in the context of a child of unknown weight requiring administration of emergency resuscitation drugs.

DOI: 10.1111/bcp.12876

View this article

• Full article (html)
• Enhanced article (html)
• PDF
• References