The predictive value of phase angle on long-term outcome after ICU admission

Stellingwerf, Franciena; Beumeler, Lise F. E.; Jong, Hilda Rijnhart-de; Boerma, E. Christiaan; Buter, Hanneke

doi:10.1016/j.clnu.2022.03.029

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…HR: 1.33 (95% CI: 1.11–1.60) when PhA was at the 5th percentile Men PhA was not dissimilar in those who developed CVD than those who did not (7.1° vs. 7.0°, p = 0.246). HR: 1.22 (95% CI: 0.92–1.60) when PhA was at the 5th percentile Women 0.3° Men 0.1° Stellingwerf et al 2022 [ 54 ] 1023 Consecutive patients, admitted to the ICU Prospective observational BIA 101 Anniversary Sport Edition analyzer, Akern Srl. Alternating current 400 mV and 50-kHz.…”

Section: Bioelectrical Phase Angle: Definition and Characteristicsmentioning

confidence: 99%

“…Admission in intensive care unit might be related to worst prognosis in case of lower PhA values [ 54 ]. Non-survivors effectively showed significantly lower PhA measurements, while values < 4.6° increased the risk of 1-year all-cause mortality by 81%, even after adjusting for confounding factors [ 54 ].…”

Section: Bioelectrical Phase Angle In Hf: Prognostic Impactmentioning

confidence: 99%

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The role of bioelectrical phase angle in patients with heart failure

Scicchitano¹,

Massari²

2022

Rev Endocr Metab Disord

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The most challenging feature of heart failure (HF) still remains the evaluation of congestion. Residual congestion at discharge and the difficulties in perfectly dosing therapies in order to balance the hydration status of the patient are the most worrisome issues when dealing with HF. The use of bioimpedance vector analysis (BIVA) might promote a different approach in the general management of patients with HF. BIVA is a reliable, fast, bedside tool able to assess the congestion status. It proved to be helpful to physicians for diagnosing congestive status, managing therapies, and providing prognostic information in the setting of HF. Bioelectrical Phase Angle (PhA) – as derived from equations related to the parameters of BIVA – recently surged as a possible biomarker for patients with HF. Studies provided data about the application of PhA in the clinical management and in the overall risk stratification of HF patients. Basically, the use of PhA might be considered as a holistic evaluation of patients with HF which includes the need for a multiparametric approach able to effectively depict the clinical status of patients. There is no definite biomarker able to comprehensively describe and identify all the features of HF patient, but scores based on molecules/techniques able to explore the different pathogenetic mechanisms of HF are desirable. The aim of this review was to provide a comprehensive evaluation of literature related to PhA role in HF and the impact of this biomarker on clinical management and risk stratification of HF patients.

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Section: Bioelectrical Phase Angle: Definition and Characteristicsmentioning

confidence: 99%

Section: Bioelectrical Phase Angle In Hf: Prognostic Impactmentioning

confidence: 99%

The role of bioelectrical phase angle in patients with heart failure

Scicchitano¹,

Massari²

2022

Rev Endocr Metab Disord

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“…The phase angle (PhA) is a parameter obtained from BIA through the relationship between the reactance and resistance of body tissues and represents the permeability or integrity of the cell membranes as a biological marker of cellular health (5,6). A previous study reported that lower PhA values in critically ill hospitalized patients were associated with increased mortality rates and complications (7,8). Pena et al (9), Barros et al (10), and Roccamatisi et al (11) reported that low preoperative PhA values measured by BIA were associated with increased rates of infections after elective surgery.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients

Lee

Kim²

2023

Front. Med.

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PurposeBioelectrical impedance analysis (BIA) has advantages of obtaining results quickly, safely, reproducibly, and non-invasively. Phase angle (PhA) is one of the parameter of BIA, its values represent the permeability or integrity of cell membrane. With the exception of C-reactive protein (CRP), few studies have estimated an association between PhA and these conventional biomarkers. Herein, we aimed to investigate the association between the PhA value and the conventional inflammatory markers in postoperative patients in intensive care unit (ICU). Also, the correlation between the change in PhA and the occurrence of infectious complication were determined.MethodsFrom July 2020 to February 2022, retrospective observation study conducted in 221 patients who admitted to ICU after abdominal surgery. BIA measurements and blood sampling were routinely performed the next morning. The relationship between PhA and the inflammatory markers were assessed after adjusting for age and body mass index. Univariate and multivariate logistic regression analysis was performed to examine the predisposing factors for postoperative infections.ResultsAmong 221 patients admitted to ICU after abdominal surgery, infectious complications occurred in 62 cases. CRP, procalcitonin, or presepsin levels were negatively correlated with PhA in both gender. (−0.295, −0.198 or −0.212 of partial correlation coefficients, respectively in males, and 0.313, −0.245 or −0.36 of partial correlation coefficients, respectively in females) But, white blood cell did not show significant association with PhA in both genders. For males, increased level of CRP on postoperative day 1 (POD1) was revealed as the significant predicting factor for postoperative infectious complication [odds ratio (OR): 1.184, 95% confidence interval (CI): 1.090–1.285, p < 0.001]. For females, increased Acute Physiology and Chronic Health Evaluation II score at admission (OR: 1.457, 95% CI: 1.068–1.987, p = 0.018), increased level of presepsin on (OR: 1.003, 95% CI: 1.001–1.006, p = 0.016) and decreased value of PhA on POD1 (OR: 0.980, 95% CI: 0.967–0.993, p = 0.003) were revealed as the significant predicting factors.ConclusionPhase angle obtained through BIA can be used as a predictor of infection as it shows a significant association with inflammatory markers. Phase angle measurements through BIA could improve patient prognosis after abdominal surgery through the careful observation of infections and early, appropriate treatment.

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“…11,12 Patients with impaired nutrition status at ICU admission, as for instance approximated by a low bioimpedance analysis (BIA) -derived phase angle, have a higher risk of 1-year mortality. 13 However, muscle loss associated with ICU admission may be reduced by providing adequate nutrition support during an ICU stay when combined with early mobilization. 14,15 To achieve this, protein adequacy during and after an ICU stay in particular may be essential in reducing catabolism in critical illness survivors.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research has indicated that a significant proportion of ICU patients is malnourished (38%–78%) or physically frail (30%) 11,12 . Patients with impaired nutrition status at ICU admission, as for instance approximated by a low bioimpedance analysis (BIA) –derived phase angle, have a higher risk of 1‐year mortality 13 . However, muscle loss associated with ICU admission may be reduced by providing adequate nutrition support during an ICU stay when combined with early mobilization 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Protein and energy intake in intensive care unit survivors during the first year of recovery: A descriptive cohort study

Beumeler,

Visser,

Buter

et al. 2023

J Parenter Enteral Nutr

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PurposeMany ICU survivors suffer long‐term health issues, affecting their quality of life. Nutritional inadequacy can limit their rehabilitation potential. This study investigates nutritional intake and support during ICU admission and recovery.MethodsIn this prospective cohort study, 81 adult ICU patients with stays ≥ 48 hours were included. Data on dietary intake, feeding strategies, baseline/ICU characteristics, and one‐year outcomes (physical health and readmission rates) were collected. The number of patients achieving 1.2 g/kg/d protein and 25 kcal/kg/d at 3, 6, and 12 months post‐ICU was recorded. The impact of dietary supplementation during the year was assessed. Baseline characteristics, intake barriers, and rehabilitation's influence on nutritional intake at 12 months were evaluated, along with inadequate intake's effect on outcomes.ResultsAfter 12 months, only 10% of 60 patients achieved 1.2 g/kg/d protein intake, while 28% reached the advised 25 kcal/kg/d energy target. Supplementary feeding significantly increased protein intake at 3, 6, and 12 months (p=0.003, p=0.012, p=0.033) and energy intake at 3 months (p=0.003). A positive correlation was found between female sex and energy intake at 12 months post‐ICU (β=4.145, p=0.043), and taste issues independently associated with higher protein intake (β=0.363, p=0.036). However, achieving upper quartile protein or energy intake did not translate into improved physical health outcomes.ConclusionThis study shows that protein and energy intake is below recommendations in the majority of ICU survivors during the first year of recovery. Continuous and improved nutritional care is urgently needed to support patients in reaching nutritional adequacy.This article is protected by copyright. All rights reserved.

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The predictive value of phase angle on long-term outcome after ICU admission

Cited by 7 publications

References 17 publications

The role of bioelectrical phase angle in patients with heart failure

The role of bioelectrical phase angle in patients with heart failure

Usefulness of phase angle on bioelectrical impedance analysis as a surveillance tool for postoperative infection in critically ill patients

Protein and energy intake in intensive care unit survivors during the first year of recovery: A descriptive cohort study

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