An Ambiguity in Child Body Surface Area Measurement

Body Surface Area (BSA) and Total Body Surface Area (TBSA) are important indicators used in different domains of medicine, playing a crucial role in oncology, toxicology, and even transplantology or cardiology. Their main (although not sole) use in medicine is to dose medications according to the patient’s BSA/TBSA. Other fields where BSA is commonly employed include the treatment of burns—the fluid doses are according to Parkland’s rule, which is based on BSA estimation. Thus, a proper estimation of BSA value directly influences the patient’s chances of survival—one can easily imagine the consequences of not administering enough fluids in the critical phase of a burned patient’s management. In medical practice, even small deviations in the estimated BSA value may have a significant impact on the patient’s treatment process and, in extreme cases, lead to their death. This problem is particularly important in the treatment of children and adolescents. The aim of our article is to present the most popular formulae used to estimate the BSA value for children in the case of minors and to discuss discrepancies between them. In the case of a 4-week-old neonate, the smallest difference in maximum BSA calculation discrepancies amounts up to 0.22 m2, which corresponds to roughly 80% of the typical BSA value for this age group, while for 12-year-old patients this parameter is 0.15 m2, equalling about 11% of the standard BSA value for this age category. The maximum deviation between the patterns reaches 0.28 m2 for 4-week-olds and over 0.75 m2 for 12-year-old children. These notable discrepancies in BSA calculations highlight the necessity for more precise and dependable methods, particularly when dealing with paediatric patients.