Bioimpedance as a measure of fluids in patients with septic shock. A prospective observational study

Madsen, Janne M.; Itenov, Theis Skovsgaard; Koch, Ellen Bjerre; Bestle, Morten H.

doi:10.1111/aas.14180

Cited by 2 publications

(3 citation statements)

References 33 publications

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“…The most likely reason for this is the lack of patient-related factors in the algorithms, but also an increased understanding of factors that lead to the substantial internal variation that we have previously described. 18 Our study suggests that, if the variations in internal validity could be managed, the use of change in bioimpedance could be further developed and potentially help identify patients with a risk of organ failure.…”

Section: Discussionmentioning

confidence: 93%

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Bioimpedance and Duration of Organ Dysfunction in Septic Shock—A Prospective Observational Study

Koch

Madsen

Wichmann

et al. 2023

J Intensive Care Med

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Rationale: Bioimpedance may be a useful tool to guide fluid treatment and avoid organ dysfunction related to fluid overload. Objective: We examined the correlation between bioimpedance and organ dysfunction in patients with septic shock. Methods: Prospective observational study of adult intensive care unit patients fulfilling the sepsis-3 criteria. Bioimpedance was measured using a body composition monitor (BCM) and BioScan Touch i8 (MBS). We measured impedance at inclusion and after 24 h and reported the impedance, change in impedance, bioimpedance-derived fluid balance, and changes in bioimpedance-derived fluid balance. Organ markers on respiratory, circulatory, and kidney function and overall disease severity were ascertained on days 1–7. The effect of bioimpedance on the change in organ function was assessed by mixed effects linear models. We considered P < .01 as significant. Measurements and Main Results: Forty-nine patients were included. None of the single baseline measurements or derived fluid balances were associated with the course of organ dysfunction. Changes in impedance were associated with the course of overall disease severity ( P < .001; with MBS), and with changes in noradrenaline dose ( P < .001; with MBS) and fluid balance ( P < .001; with BCM). The changes in bioimpedance-derived fluid balance were associated with changes in noradrenaline dose ( P < .001; with BCM), cumulative fluid balances ( P < .001; with MBS), and lactate concentrations ( P < .001; with BCM). Conclusions: Changes in bioimpedance were correlated with the duration of overall organ failure, circulatory failure, and fluid status. Single measurements of bioimpedance were not associated with any changes in organ dysfunction.

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Section: Discussionmentioning

confidence: 93%

“…The internal validity and efficacy of the 2 devices were examined in another study using the same population. 18…”

Section: Design and Settingmentioning

confidence: 99%

Bioimpedance and Duration of Organ Dysfunction in Septic Shock—A Prospective Observational Study

Koch

Madsen

Wichmann

et al. 2023

J Intensive Care Med

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“…Recent (systematic) reviews have pointed towards the issues in the validation of BIA-derived parameters against the gold standard, as the calculation of fluid composition and cumulative fluid balance is not without error or bias in critically ill patients [19,22,30]. Therefore it was not surprising that bioelectrical impedance analysis had no systematic errors or bias, but wide limits of agreement [50]. On the other hand changes in bioimpedance were correlated with the duration of overall organ failure, circulatory failure, and fluid status.…”

Section: Importance Of Fluid Overload and Intra-abdominal Hypertensionmentioning

confidence: 99%

Comparison of Bioelectrical Impedance Analysis (BIA)-Derived Parameters in Healthy Volunteers and Critically Ill Patients

Cleymaet,

D’Hondt,

Scheinok

et al. 2023

Life

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Objective: To compare bioelectrical impedance analysis (BIA)-derived parameters in healthy volunteers and critically ill patients and to assess its prognostic value in an ICU patient cohort. Design: Retrospective, observational data analysis. Setting: Single centre, tertiary-level ICU (Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg Hospital). Patients: 101 patients and 101 healthy subjects, participants of International Fluid Academy Days. Measurements and main results: Compared to healthy volunteers, both male and female ICU patients had significantly higher values for total body water (TBW), extracellular water (ECW), extracellular fluid (ECF), plasma, and interstitial fluid volumes. The phase angle was significantly lower and the malnutrition index was significantly higher in ICU patients, regardless of gender. Non-survivors in the ICU had significantly higher extracellular water content (ECW, 50.7 ± 5.1 vs. 48.9 ± 4.3%, p = 0.047) and accordingly significantly lower intracellular water (ICW, 49.2 ± 5.1 vs. 51.1 ± 4.3%, p = 0.047). The malnutrition index was also significantly higher in non-survivors compared to survivors (0.94 ± 0.17 vs. 0.87 ± 0.16, p = 0.048), as was the capillary leak index (ECW/ICW). Conclusions: Compared to healthy volunteers, this study observed a higher malnutrition index and TBW in ICU patients with an accumulation of fluids in the extracellular compartment. ICU non-survivors showed similar results, indicating that ICU patients and a fortiori non-survivors are generally overhydrated, with increased TBW and ECW, and more undernourished, as indicated by a higher malnutrition index.

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Bioimpedance as a measure of fluids in patients with septic shock. A prospective observational study

Cited by 2 publications

References 33 publications

Bioimpedance and Duration of Organ Dysfunction in Septic Shock—A Prospective Observational Study

Bioimpedance and Duration of Organ Dysfunction in Septic Shock—A Prospective Observational Study

Comparison of Bioelectrical Impedance Analysis (BIA)-Derived Parameters in Healthy Volunteers and Critically Ill Patients

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