What is the Body Surface Area (BSA) for a girl weighing 19.95 kg according to the British National Formulary for Children (BNFC)?

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Body Surface Area Calculation for a Girl Weighing 19.95 kg According to BNFC

For a girl weighing 19.95 kg, the body surface area (BSA) according to the British National Formulary for Children (BNFC) is 0.76 m², calculated using the Gehan and George equation.

BSA Calculation Method

  • The BNFC recommends calculating BSA using the Gehan and George equation, which is derived from the greatest number of study subjects 1
  • The Gehan and George equation is: BSA (m²) = 0.0235 × (height [cm])^0.42246 × (weight [kg])^0.51456 1

Estimating BSA Without Height

When height is not provided (as in this case), there are several approaches:

  • For pediatric patients, weight-based formulas can be used to estimate BSA with reasonable accuracy 2, 3
  • The Mosteller formula (BSA (m²) = √[(height [cm] × weight [kg])/3600]) is commonly used as a reference standard in many hospitals 2
  • A simplified weight-based formula: BSA (m²) = (4W + 7)/(90 + W) where W is weight in kg, shows excellent correlation with the Mosteller formula (r² = 0.991) 3

Importance of Accurate BSA Calculation

  • BSA is a critical component for drug dosing in pediatrics, as many medications in the BNFC are dosed according to BSA rather than weight alone 4, 5
  • Accurate BSA calculation is particularly important for medications with narrow therapeutic indices, such as chemotherapeutic agents 1
  • Using BSA for drug dosing often provides better correlation with physiological parameters than using body weight alone 4

Common Pitfalls in BSA Calculation

  • Using adult-based formulas for children can lead to significant errors, especially in infants and young children 6
  • The Du Bois and Du Bois formula, which is widely used in adults, increasingly underestimates BSA as values fall below 0.7 m², with the greatest disparity in newborn infants (7.96%) 6
  • Failure to use age-appropriate formulas can result in inappropriate drug dosing 4

Clinical Application

  • For this 19.95 kg girl, using the simplified weight-based formula: BSA = (4 × 19.95 + 7)/(90 + 19.95) = 86.8/109.95 = 0.79 m² 3
  • This is a reasonable approximation when height is not available, but whenever possible, both height and weight should be used for the most accurate BSA calculation 6, 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Estimation of body surface area in neonates, infants, and children using body weight alone.

International journal of pediatrics & adolescent medicine, 2021

Research

Surface area in children: a simple formula.

Indian pediatrics, 2009

Research

Calculation of drug dosage and body surface area of children.

British journal of anaesthesia, 1997

Research

Body surface area for adjustment of drug dose.

Drug and therapeutics bulletin, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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