Longitudinal and transversal bioimpedance measurements in addition to diagnosis of heart failure

Ribas, Núria; Nescolarde, Lexa; Domingo, Manel Puig; Gastelurrutia, Paloma; Bayés‐Genís, Antoni; Rosell, J.

doi:10.1088/1742-6596/224/1/012099

Cited by 3 publications

(4 citation statements)

References 4 publications

(5 reference statements)

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“…Accuracy of bioimpedance vector analysis can be reduced by diaphoresis, hirsutism, incorrect electrode placement, cutaneous alterations, or improper electrical grounding. Bioimpedance spectroscopy is also being investigated in patients with heart failure (70). Unfortunately, no existing bioimpedance-based method can differentiate intravascular from interstitial extracellular fluid volume, a distinction that is critical for safe and effective fluid removal (69,70).…”

Section: Knowledge Gaps In the Use Of Extracorporeal Uf In Heart Failurementioning

confidence: 99%

“…Specific hemodynamic targets indicative of optimal fluid status should be established in individual patients, similar to the strategies used to guide medication adjustment in studies of pulmonary artery pressure sensors (63). Different UF rates should be tested in terms of their ability to reach these hemodynamic targets without causing renal tubular damage, as detectable by increase in urine levels of biomarkers, such as NGAL (70,73,76). This will require simultaneous measurement of the selected hemodynamic values and biomarker levels capable of differentiating rises in serum creatinine due to decreases in glomerular filtration rate produced by intravascular fluid removal from those reflective of renal injury.…”

Section: Knowledge Gaps In the Use Of Extracorporeal Uf In Heart Failurementioning

confidence: 99%

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Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure

Costanzo

Ronco

Abraham

et al. 2017

Journal of the American College of Cardiology

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More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. Simplified ultrafiltration devices permit fluid removal in lower-acuity hospital settings, but with conflicting results regarding safety and efficacy. Ultrafiltration performed at fixed rates after onset of therapy-induced increased serum creatinine was not superior to standard care and resulted in more complications. In contrast, compared with diuretic agents, some data suggest that adjustment of ultrafiltration rates to patients’ vital signs and renal function may be associated with more effective decongestion and fewer heart failure events. Essential aspects of ultrafiltration remain poorly defined. Further research is urgently needed, given the burden of congestion and data suggesting sustained benefits of early and adjustable ultrafiltration.

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Section: Knowledge Gaps In the Use Of Extracorporeal Uf In Heart Failurementioning

confidence: 99%

Section: Knowledge Gaps In the Use Of Extracorporeal Uf In Heart Failurementioning

confidence: 99%

Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure

Costanzo

Ronco

Abraham

et al. 2017

Journal of the American College of Cardiology

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“…Bioimpedance spectroscopy is also being investigated in patients with heart failure. [54] Unfortunately, no existing bioimpedance-based method can differentiate intravascular from interstitial extracellular fluid volume, a distinction that is critical for safe and effective fluid removal. [53,54]…”

Section: Knowledge Gaps In the Use Of Ultrafiltration In Acute Heart mentioning

confidence: 99%

Ultrafiltration in Acute Heart Failure

Costanzo

2019

Card Fail Rev

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Congestion is the predominant cause of more than 1 million annual heart failure hospitalisations and recurrent fluid overload predicts poor outcomes. Unresolved congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No pharmacological approach for acute heart failure has reduced these deleterious consequences. Simplified ultrafiltration devices permit fluid removal in lower acuity hospital settings, but results regarding safety and efficacy have been variable. However, adjustment of ultrafiltration rates to patients’ vital signs and renal function has been associated with more effective decongestion and fewer heart failure events. Many aspects of ultrafiltration, including patient selection, fluid removal rates, venous access, prevention of therapyrelated complications and costs, require further investigation.

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“…Impedance values are then used to quantify intracellular fluid (ICF), extracellular fluid (ECF), and total body water (TBW), as well as other fluid and tissue parameters ( 7 ). BIS has enabled improved discrimination of fluid overload from HF as a cause of dyspnea, and is sensitive to changes in both pulmonary and peripheral edema ( 8 – 12 ). In addition, BIS measurements of ECF ( 13 , 14 ) and TBW ( 14 – 18 ) have also been shown to correlate strongly with gold-standard bromide and deuterium oxide dilution methods, respectively ( Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of Fluid Volume Assessment in Heart Failure Patients Using Bioimpedance Spectroscopy

Accardi

Matsubara²,

Gaw

et al. 2021

Front. Cardiovasc. Med.

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Background: Bioimpedance spectroscopy (BIS) is a non-invasive method used to measure fluid volumes. In this report, we compare BIS measurements from patients with heart failure (HF) to those from healthy adults, and describe how these point-of-care fluid volume assessments may be applied to HF management.Methods and results: Fluid volumes were measured in 64 patients with NYHA class II or III HF and 69 healthy control subjects. BIS parameters including extracellular fluid (ECF), intracellular fluid (ICF), total body water (TBW), and ECF as a percentage of TBW (ECF%TBW) were analyzed. ECF%TBW values for the HF and control populations differed significantly (49.2 ± 3.2% vs. 45.2 ± 2.1%, respectively; p < 0.001); both distributions satisfied criteria for normality. Interquartile ranges did not overlap (46.7–51.0% vs. 43.8–46.4%, respectively; p < 0.001). Subgroup analyses of HF patients who underwent transthoracic echocardiography showed that impedance measurements correlated with inferior vena cava size (Pearson correlation −0.73, p < 0.0001). A case study is presented for illustrative purposes.Conclusions: BIS-measured ECF%TBW values were significantly higher in HF patients as compared to adults without HF. We describe three strata of ECF%TBW (normal, elevated, fluid overload) that may aid in clinical risk stratification and fluid volume monitoring of HF patients.Clinical Trial Registration: COMPARE – www.ClinicalTrials.gov; IMPEL – www.ClinicalTrials.gov; Heart Failure at Home – www.ClinicalTrials.gov, identifier: NCT02939053; NCT02857231; NCT04013373.

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Longitudinal and transversal bioimpedance measurements in addition to diagnosis of heart failure

Cited by 3 publications

References 4 publications

Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure

Extracorporeal Ultrafiltration for Fluid Overload in Heart Failure

Ultrafiltration in Acute Heart Failure

Clinical Utility of Fluid Volume Assessment in Heart Failure Patients Using Bioimpedance Spectroscopy

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