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Measuring body weight of bed bound patients
How important is weighing patients regularly?
Weighing patients regularly is necessary for early detection of sudden weigh fluctuations.
As body fat and muscle mass change slowly, any sudden body weight change reflects changes of body water, which makes up 60 % of the total body weight.
Consequently, as body weight is such a sensitive indicator of body water fluctuations, its close monitoring ensures early diagnosis of fluid overload or depletion.
More specifically, monitoring body weight becomes most important for:
- Treatment of dehydration.
- Prevention of fluid overload.
- Estimation of creatinine clearance.
- Estimation of blood osmotic pressure.
- Estimation of medication dosages.
- Watching patient’s nutrition.
In a study which was published in 2003 in the Acta Hematologica journal from Mank and associates, where the dangers of fluid overload in patients receiving chemotherapy are mentioned, the reliability of estimating fluid input and output are questioned as a means of estimating water balance:
“…The reliability of measuring fluid input/output is uncertain. Moreover,
this measurement is redundant, complex, labor-intensive….body weight can
safely be used as the only parameter for monitoring fluid retention in
case of hyper hydration during chemotherapy."[4]
But according to Dragan the body weight of bed-confined patients is usually roughly estimated rather than measured. These estimations are almost always inaccurate:
“…However, the body weight of bedridden patients is usually erroneously
assumed in everyday practice, rather than measured.”
In another study published in Clinical Toxicology by Jones and Dragan, the need to weigh patients in clinical toxicology is stressed. Despite all this, these patients are not being properly weighed and doctors simply guess their body weight. The authors emphasize that every patient receiving potentially toxic medications must be formally weighed:
"…The weight of patients is important in clinical toxicology … However, patients are often not weighed and doctors and nurses frequently estimate the weight of patients; these estimates of bodyweight are often inaccurate …All patients given medications based on bodyweight should be formally weighed.[5]"
Raveh, Copyt and associates emphasize that weighing patients can assist in more correct therapeutic plans, reducing the risk of nephrotoxicity. They also note that weighing must be done accurately. Special weighing devices must be used for bedridden patients:
"…weighing patients (possibly by using special devices for bedridden patients) …might lead to more appropriate therapy and diminish the risk of nephrotoxicity …actually weighing patients, rather than estimating their weight.[6]"