Bioelectrical impedance analysis during deresuscitation: correlation and agreement with cumulative fluid balance in ICU patients

体液 生物电阻抗分析 细胞外液 医学 秩相关 斯皮尔曼秩相关系数 平衡(能力) 内科学 麻醉 数学 化学 统计 体重 体质指数 物理疗法 细胞外 生物化学
作者
Martin Ruste,Charlotte Chabanol,Jean-Luc Fellahi,Matthias Jacquet‐Lagrèze
出处
期刊:Journal of Clinical Monitoring and Computing [Springer Nature]
卷期号:37 (2): 679-687 被引量:1
标识
DOI:10.1007/s10877-022-00923-0
摘要

Bioelectrical impedance analysis (BIA) is a promising tool to evaluate the body composition of critically-ill patients. The present study aimed to assess its value as a fluid management monitoring tool during standardized deresuscitation strategy. A historical cohort of critically-ill adult patients with fluid overload and continuous renal replacement therapy was used to explore both relationship and agreement between changes in cumulative fluid balance and BIA-derived hydration variables within the 5 days following initiation of deresuscitation strategy using net ultrafiltration. Correlations were described using Spearman’s rank correlation coefficient, and agreement using Bland–Altman analysis for repeated measurements. Sixty-one couples of fluid shift measurements from 30 patients were analyzed. The deresuscitation strategy induced a negative mean (± SD) cumulative fluid balance (− 4.2 ± 3.8 L) and a significant decrease in extra- and intracellular water (P < 0.001). Decreases in extra- and intracellular water were independent of weight variations inputted in the BIA device. Total body water (rho = 0.63), extracellular water (rho = 0.68), and intracellular water (rho = 0.67) were significantly correlated with cumulative fluid balance (all P values < 0.001). The limits of agreement did not allow interchangeability for a delta of 2L between cumulative fluid balance and BIA-derived hydration variables (P > 0.05). BIA hydration-derived variables are significantly correlated with cumulative fluid balance but the large limits of agreements exclude interchangeability of the measures.
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