[Music]
in the last lesson on arts management i
mentioned about using ideal body weight
or ibw when we're setting our title
volume goals in this quick lesson here i
just wanted to review over exactly what
this was so our ideal body weight which
is also something referred to as
predicted body weight or pbw that this
is as the name suggests the ideal or
expected weight for someone given their
height and gender so the concept was
initially introduced by ben devine in
1974. now the ideal body weight may and
often does differ from the patient's
actual or total body weight when we
actually weigh them especially in the
united states as well as many other
places around the world the average
person is actually larger than what we
would expect and so a patient's
composition of that and muscle has a
different influence based on the
proportions of each it was found that
some medications metabolism was related
more to a person's ideal body weight
than their actual body weight in
addition men when we're comparing them
to women of the same height are
generally a little bit larger so this is
something that we also have to account
for and then in the context of the last
lesson on ards a person's lung size
doesn't change despite their total body
weight so for two people of the same
height but different weights we would
actually expect their lungs to be
approximately the same size so what this
means especially for our lung protective
ventilation as well as the use of some
medications that we need to calculate
our patients ideal body weight and then
use that number instead to ensure safety
for them so let's go and talk about how
it is that we calculate it now there's
actually many different methods to
calculating this but the most popular
one is actually the divine formula for
adults so we have two different slightly
different calculations for both men and
women so for men we're going to start
with 50 kilograms or 110 pounds to that
we're going to add 0.9 kilograms or 2
pounds times their height in centimeters
minus 152.
for women we're basically just beginning
with a slightly different starting
number so we're going to begin with 45.5
kilograms or 100 pounds again plus 0.9
kilograms or 2 pounds times their height
minus 152. now fortunately we actually
have charts of these calculated out so
you don't actually have to do this
calculation as well as most charting
systems will automatically determine
what our patient's idle body weight is
but it is helpful to kind of understand
how we got to these numbers so let's go
through just a couple of quick examples
here just to help cement the calculation
in here so first we're going to take a
man who is six foot tall and figure out
what his ideal body weight would be so
six foot is equal to 72 inches which is
equal to 182 centimeters so if we're
working with kilograms here we'll take
50 kilograms plus 0.9 times 182 minus
152 or if we're working in pounds we do
110 plus 2 times the difference of 182
minus 152 so we know here in kilograms
we would be doing 0.9 times 30 which
gives us 50 plus 27 which equals 77
kilograms this would be our ideal body
weight if we were continuing in pounds
we'd have 110 plus 2 times 30 which
equals 110 plus 60 giving us 170 pounds
of ideal body weight and then next let's
take a woman who is 5 foot 5 inches so 5
foot 5 inches is 65 inches which equals
165 centimeters so here we're going to
be starting with a different beginning
number so we're going to take 45.5
kilograms plus 0.9 kilograms times 165
minus 152. in pounds that would be a
hundred pounds plus two times 165 minus
152. so we know that difference is 13 so
on the kilogram side we'd have 45.5
plus 0.9 times 13 which gives us 11.7
adding that to 45.5 gives us 57.2
kilograms of ideal body weight again if
we're doing this in pounds we'd have 100
pounds plus 2 times 13 which gives us
100 pounds plus 26 or 126 pounds of
ideal body weight so again pretty easy
calculation and oftentimes we'll just
plug in what their height is and we've
already got it figured out what their
actual ideal body weight is but
hopefully you guys kind of understand
why it is that this would be an
important thing especially when we're
doing the lung protective ventilation
for arts pretty simple lesson hope you
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