1
|
Oyake K, Katai M, Yoneyama A, Ikegawa H, Kani S, Momose K. Comparisons of heart rate variability responses to head-up tilt with and without abdominal and lower-extremity compression in healthy young individuals: a randomized crossover study. Front Physiol 2024; 14:1269079. [PMID: 38260095 PMCID: PMC10800437 DOI: 10.3389/fphys.2023.1269079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction: Abdominal and lower-extremity compression techniques can help reduce orthostatic heart rate increases. However, the effects of body compression on the cardiac autonomic systems, which control heart rate, remain unclear. The primary objective of this study was to compare heart rate variability, a reflection of cardiac autonomic regulation, during a head-up tilt test with and without abdominal and lower-extremity compression in healthy young individuals. The secondary objective was to conduct a subgroup analysis, considering participant sex, and compare heart rate and heart rate variability responses to head-up tilt with and without compression therapy. Methods: In a randomized crossover design, 39 healthy volunteers (20 females, aged 20.9 ± 1.2 years) underwent two head-up tilt tests with and without abdominal and lower-extremity compression. Heart rate and heart rate variability parameters were measured during the head-up tilt tests, including the Stress Index, root mean square of successive differences between adjacent R-R intervals, low- and high-frequency components, and low-to-high frequency ratio. Results: Abdominal and lower-extremity compression reduced the orthostatic increase in heart rate (p < 0.001). The tilt-induced changes in heart rate variability parameters, except for the low-frequency component, were smaller in the compression condition than in the no-compression condition (p < 0.001). These results were consistent regardless of sex. Additionally, multiple regression analysis with potentially confounding variables revealed that the compression-induced reduction in Stress Index during the head-up tilt position was a significant independent variable for the compression-induced reduction in heart rate in the head-up tilt position (coefficient = 0.411, p = 0.025). Conclusion: Comparative analyses revealed that abdominal and lower-extremity compression has a notable impact on the compensatory sympathetic activation and vagal withdrawal typically observed during orthostasis, resulting in a reduction of the increase in heart rate. Furthermore, this decrease in heart rate was primarily attributed to the attenuation of cardiac sympathetic activity associated with compression. Our findings could contribute to the appropriate application of compression therapy for preventing orthostatic tachycardia. This study is registered with UMIN000045179.
Collapse
Affiliation(s)
- Kazuaki Oyake
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, Japan
| | | | | | | | | | | |
Collapse
|
2
|
Schotman J, Rolleman N, van Borren M, Wetzels J, Kloke H, Reichert L, de Boer H. Accuracy of Bioimpedance Spectroscopy in the Detection of Hydration Changes in Patients on Hemodialysis. J Ren Nutr 2023; 33:193-200. [PMID: 34922812 DOI: 10.1053/j.jrn.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/16/2021] [Accepted: 11/03/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The body composition monitor (BCM) is a bioimpedance spectroscopy device, specifically developed for patients on hemodialysis (HD) to improve ultrafiltration (UF) programming, based on an objective assessment of the degree of overhydration (OH) at the start of HD. However, its acceptance in clinical practice remains limited because of concerns about the accuracy at the individual level. The aim of this study is to examine the performance of the BCM and to identify means of improvement. METHODS Precision of the OH estimate was assessed by 6 consecutive measurements in 24 patients on HD. Accuracy was examined in 45 patients, by comparing the change in OH (ΔOH) during HD with UF volume. Accuracy was considered acceptable if the volume error in individual patients was ≤0.5 L. RESULTS The OH estimate had an analytical precision of 1.0 ± 0.4%. The correlation between UF volume and ΔOH was moderate (Slope = 0.66, R2 = 0.44, P < .001) and indicated underestimation of UF volume, in particular for high UF volumes. Accuracy at individual level was highly variable. A volume error >0.5 L occurred in 44% of patients. Accuracy improved over the course of HD, with a decrease in total error range from 2.3 L in the first hour to 1.1 L in the final hour of HD. CONCLUSIONS The accuracy of BCM volume change estimates is highly variable and below requirements of daily practice. Improvement may be achieved by a switch to an end-of-HD measurement.
Collapse
Affiliation(s)
- Jantine Schotman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
| | - Nick Rolleman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Marcel van Borren
- Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, the Netherlands
| | - Jack Wetzels
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Heinrich Kloke
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Louis Reichert
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Hans de Boer
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| |
Collapse
|
3
|
Garr Barry V, Chiang JL, Bowman KG, Johnson KD, Gower BA. Bioimpedance-Derived Membrane Capacitance: Clinically Relevant Sources of Variability, Precision, and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:686. [PMID: 36613010 PMCID: PMC9819400 DOI: 10.3390/ijerph20010686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Membrane capacitance (CM), a bioimpedance-derived measure of cell membrane health, has been suggested as an indicator of health status. However, there are few published data to support its use in clinical settings. Hence, this study evaluated clinically relevant sources of variation, precision, and reliability of CM measurements. This longitudinal study included 60 premenopausal women. Sources of variability (e.g., demographics, body composition, serum measures, diet) were identified by stepwise regression. Precision and reliability were assessed by the coefficient of variation (CV), intraclass correlation coefficients (ICC), and technical error of the measurement (TEM) for intra-day (30 min apart) and inter-day measurements (7-14 days apart). Body composition, temperature, and metabolic activity were identified as sources of variability. CM measurements had high precision (CV = 0.42%) and high reliability for intra-day (ICC = 0.996) and inter-day (ICC = 0.959) measurements, independent of menstrual cycle and obesity status. Our results showed that CM measurements are sensitive to clinical factors and have high precision and reliability. The results of this study suggest that CM is sufficiently reliable for health status monitoring in conditions with variation in body composition, metabolic activity, or body temperature among premenopausal women.
Collapse
Affiliation(s)
- Valene Garr Barry
- Department of Obstetrics and Gynecology, Division of Clinical Research, School of Medicine in St. Louis, Washington University, St. Louis, MO 63108, USA
| | - Jasmine L. Chiang
- Department of Obstetrics and Gynecology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Kaylan G. Bowman
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Kristina D. Johnson
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Barbara A. Gower
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| |
Collapse
|
4
|
Więch P, Wołoszyn F, Trojnar P, Skórka M, Bazaliński D. Does Body Position Influence Bioelectrical Impedance? An Observational Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9908. [PMID: 36011541 PMCID: PMC9408608 DOI: 10.3390/ijerph19169908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
As the availability of various bioelectric impedance analysis (BIA) tools is increasing, the patient's position during the test may be of significant importance for the comparability of the results. An observational pilot study was undertaken between March and May 2021 at the Center for Innovative Research in Medical and Natural Sciences at the University of Rzeszow, Rzeszów, Poland. All participants (n = 49: M: 21.05 y ± 1.12 vs. F: 21.34 y ± 2.06) were subjected to measurements of selected nutritional status indicators and body components in three positions: lying, sitting and standing. The body composition indicators were obtained using a bioelectrical impedance device, AKERN BIA 101 Anniversary Sport Edition Analyzer (Akern SRL, Pontassieve, Florence, Italy). The results were analyzed using dedicated software (BodygramPlus 1.2.2.12 from AKERN 2016, Florence, Italy). Our observations indicate that there is a significant difference between lying and standing as well as sitting and standing with respect to anthropometric and nutritional indicators (resistance, reactance, phase angle, standardized phase angle, body cell mass index and fat-free mass index) and body composition components, with particular reference to intracellular and extracellular water. The described differences are significant for both sexes. This study showed that this significantly influenced the scores of components directly related to resistance, reactance and hydrated cell mass, while not affecting the percentages or absolute values of fat and fat-free mass.
Collapse
Affiliation(s)
- Paweł Więch
- Department of Nursing and Public Health, Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland
- Department of Nursing, Institute of Social Sciences and Health Protection, East European State Higher School in Przemysl, 37-700 Przemysl, Poland
| | - Filip Wołoszyn
- Department of Human Physiology, Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Patrycja Trojnar
- Medical College, University of Information Technology and Management, 35-225 Rzeszow, Poland
| | - Mateusz Skórka
- Orthopedics Department, St. Hedvig Clinical Provincial Hospital, 35-301 Rzeszow, Poland
| | - Dariusz Bazaliński
- Department of Nursing and Public Health, Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland
| |
Collapse
|
5
|
Wang LC, Raimann JG, Tao X, Preciado P, Thwin O, Rosales L, Thijssen S, Kotanko P, Zhu F. Estimation of fluid status using three multifrequency bioimpedance methods in hemodialysis patients. Hemodial Int 2022; 26:575-587. [PMID: 35719044 DOI: 10.1111/hdi.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 05/02/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Segmental eight-point bioimpedance has been increasingly used in practice. However, whether changes in bioimpedance analysis components before and after hemodialysis (HD) using this technique in a standing position is comparable to traditional whole-body wrist-to-ankle method is still unclear. We aimed to investigate the differences between two eight-point devices (InBody 770 and Seca mBCA 514) and one wrist-to-ankle (Hydra 4200) in HD patients and healthy subjects in a standing position. METHODS Thirteen HD patients were studied pre- and post-HD, and 12 healthy subjects once. Four measurements were performed in the following order: InBody; Seca; Hydra; and InBody again. Electrical equivalent models by each bioimpedance method and the fluid volume estimates by each device were also compared. FINDINGS Overall, total body water (TBW) was not different between the three devices, but InBody showed lower extracellular water (ECW) and higher intracellular water (ICW) compared to the other two devices. When intradialytic weight loss was used as a surrogate for changes in ECW (∆ECW) and changes in TBW (∆TBW), ∆ECW was underestimated by Hydra (-0.79 ± 0.89 L, p < 0.01), InBody (-1.44 ± 0.65 L, p < 0.0001), and Seca (-0.32 ± 1.34, n.s.). ∆TBW was underestimated by Hydra (-1.14 ± 2.81 L, n.s.) and InBody (-0.52 ± 0.85 L, p < 0.05) but overestimated by Seca (+0.93 ± 3.55 L, n.s.). DISCUSSION Although segmental eight-point bioimpedance techniques provided comparable TBW measurements not affected by standing over a period of 10-15 min, the ECW/TBW ratio appeared to be significantly lower in InBody compared with Seca and Hydra. Results from our study showed lack of agreement between different bioimpedance devices; direct comparison of ECW, ICW, and ECW/TBW between different devices should be avoided and clinicians should use the same device to track the fluid status in their HD population in a longitudinal direction.
Collapse
Affiliation(s)
| | | | - Xia Tao
- Renal Research Institute, New York, New York, USA
| | | | - Ohnmar Thwin
- Renal Research Institute, New York, New York, USA
| | | | | | - Peter Kotanko
- Renal Research Institute, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Fansan Zhu
- Renal Research Institute, New York, New York, USA
| |
Collapse
|
6
|
Tinsley GM, Stratton MT, Harty PS, Williams AD, White SJ, Rodriguez C, Dellinger JR, Johnson BA, Smith RW, Trexler ET. Influence of Acute Water Ingestion and Prolonged Standing on Raw Bioimpedance and Subsequent Body Fluid and Composition Estimates. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2022; 13:10-20. [PMID: 35646197 PMCID: PMC9124033 DOI: 10.2478/joeb-2022-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Indexed: 06/15/2023]
Abstract
This study evaluated the influence of acute water ingestion and maintaining an upright posture on raw bioimpedance and subsequent estimates of body fluids and composition. Twenty healthy adults participated in a randomized crossover study. In both conditions, an overnight food and fluid fast was followed by an initial multi-frequency bioimpedance assessment (InBody 770). Participants then ingested 11 mL/kg of water (water condition) or did not (control condition) during a 5-minute period. Thereafter, bioimpedance assessments were performed every 10 minutes for one hour with participants remaining upright throughout. Linear mixed effects models were used to examine the influence of condition and time on raw bioimpedance, body fluids, and body composition. Water consumption increased impedance of the arms but not trunk or legs. However, drift in leg impedance was observed, with decreasing values over time in both conditions. No effects of condition on body fluids were detected, but total body water and intracellular water decreased by ~0.5 kg over time in both conditions. Correspondingly, lean body mass did not differ between conditions but decreased over the measurement duration. The increase in body mass in the water condition was detected exclusively as fat mass, with final fat mass values ~1.3 kg higher than baseline and also higher than the control condition. Acute water ingestion and prolonged standing exert practically meaningful effects on relevant bioimpedance variables quantified by a modern, vertical multi-frequency analyzer. These findings have implications for pre-assessment standardization, methodological reporting, and interpretation of assessments.
Collapse
Affiliation(s)
- Grant M. Tinsley
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Matthew T. Stratton
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Patrick S. Harty
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Abegale D. Williams
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Sarah J. White
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Christian Rodriguez
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Jacob R. Dellinger
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Baylor A. Johnson
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Robert W. Smith
- Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | | |
Collapse
|
7
|
Lyons-Reid J, Ward LC, Tint MT, Kenealy T, Godfrey KM, Chan SY, Cutfield WS. The influence of body position on bioelectrical impedance spectroscopy measurements in young children. Sci Rep 2021; 11:10346. [PMID: 33990622 PMCID: PMC8121940 DOI: 10.1038/s41598-021-89568-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022] Open
Abstract
Bioelectrical impedance techniques are easy to use and portable tools for assessing body composition. While measurements vary according to standing vs supine position in adults, and fasting and bladder voiding have been proposed as additional important influences, these have not been assessed in young children. Therefore, the influence of position, fasting, and voiding on bioimpedance measurements was examined in children. Bioimpedance measurements (ImpediMed SFB7) were made in 50 children (3.38 years). Measurements were made when supine and twice when standing (immediately on standing and after four minutes). Impedance and body composition were compared between positions, and the effect of fasting and voiding was assessed. Impedance varied between positions, but body composition parameters other than fat mass (total body water, intra- and extra-cellular water, fat-free mass) differed by less than 5%. There were no differences according to time of last meal or void. Equations were developed to allow standing measurements of fat mass to be combined with supine measurements. In early childhood, it can be difficult to meet requirements for fasting, voiding, and lying supine prior to measurement. This study provides evidence to enable standing and supine bioimpedance measurements to be combined in cohorts of young children.
Collapse
Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Leigh C Ward
- Liggins Institute, University of Auckland, Auckland, New Zealand.,School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
| |
Collapse
|
8
|
Varanoske AN, Coker NA, Johnson BADI, Belity T, Wells AJ. Muscle Quality, Measured by Ultrasound-Derived Corrected Echo Intensity, Does not Affect Changes in Cross-sectional Area of the Vastus Lateralis Following Recumbent Rest. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/8756479320967277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Recumbent rest elicits a decrease in muscle size of the lower extremity, but the extent of decrease may be related to differences in muscle quality. This could have implications for ultrasound-derived measures of muscle size, particularly in individuals with a large proportion of intramuscular contractile elements. The research objective was to determine whether decreases in muscle size following recumbent rest are related to ultrasound-derived corrected echo intensity in resistance-trained males. Methods: Cross-sectional area (CSA), echo intensity (EI), subcutaneous fat thickness (SFT), and EI corrected for SFT (EICor) of the vastus lateralis (VL) were measured via ultrasonography in 30 resistance-trained males. Measures were obtained immediately following recumbency (T0) and 15 minutes after recumbency (T15). The association between EICor and percentage change in CSA (%ΔCSA) from T0 to T15 was examined. Comparisons of morphological characteristics were examined between a subset of participants with the lowest (LO; n = 10; <33rd percentile) and highest (HI; n = 10; >66th percentile) EICor. Results: EICor was not correlated with %ΔCSA ( P = .151), and the decrease in CSA from T0 to T15 did not differ between the LO and HI groups. Conclusions: Muscle quality (EICor) is not related to the decrease in CSA of the VL following recumbent rest among resistance-trained, young males. The time frame of muscle CSA acquisition should not differ based solely on differences in muscle quality.
Collapse
Affiliation(s)
- Alyssa N. Varanoske
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Nicholas A. Coker
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Bri-Ana D. I. Johnson
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Tal Belity
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Adam J. Wells
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
- Exercise Physiology Intervention and Collaboration (EPIC) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL
| |
Collapse
|
9
|
Dellinger JR, Johnson BA, Benavides ML, Moore ML, Stratton MT, Harty PS, Siedler MR, Tinsley GM. Agreement of bioelectrical resistance, reactance, and phase angle values from supine and standing bioimpedance analyzers. Physiol Meas 2021; 42. [PMID: 33592586 DOI: 10.1088/1361-6579/abe6fa] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/16/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Bioimpedance devices are commonly used to assess health parameters and track changes in body composition. However, the cross-sectional agreement between different devices has not been conclusively established. Thus, the objective of this investigation was to examine the agreement between raw bioelectrical variables (resistance, reactance, and phase angle at the 50-kHz frequency) obtained from three bioimpedance analyzers. APPROACH Healthy male (n=76, Mean±SD; 33.8±14.5 years; 83.9±15.1 kg; 179.4±6.9 cm) and female (n=103, Mean±SD; 33.4±15.9 years; 65.6±12.1 kg; 164.9±6.4 cm) participants completed assessments using three bioimpedance devices: supine bioimpedance spectroscopy (BIS), supine single-frequency bioelectrical impedance analysis (SFBIA), and standing multi-frequency bioelectrical impedance analysis (MFBIA). Differences in raw bioelectrical variables between the devices were quantified via one-way analysis of variance for the total sample and for each sex. Equivalence testing was used to determine equivalence between methods. MAIN RESULTS Significant differences in all bioelectrical variables were observed between the three devices when examining the total sample and males only. The devices appeared to exhibit slightly better agreement when analyzing female participants only. Equivalence testing using the total sample as well as males and females separately revealed that resistance and phase angle were equivalent between the supine devices (BIS, SFBIA), but not with the standing analyzer (MFBIA). SIGNIFICANCE The present study demonstrated disagreement between different bioimpedance analyzers for quantifying raw bioelectrical variables, with the poorest agreement between devices that employed different body positions during testing. These results suggest that researchers and clinicians should employ device-specific reference values to classify participants based on raw bioelectrical variables, such as phase angle. If reference values are needed but are unavailable for a particular bioimpedance analyzer, the set of reference values produced using the most similar analyzer and reference population should be selected.
Collapse
Affiliation(s)
- Jacob R Dellinger
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| | - Baylor A Johnson
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| | - Marqui L Benavides
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| | - Michael Lane Moore
- Mayo Clinic School of Medicine - Scottsdale Campus, Scottsdale, 85259-5452, UNITED STATES
| | - Matthew T Stratton
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| | - Patrick S Harty
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| | - Madelin R Siedler
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, UNITED STATES
| |
Collapse
|
10
|
Lindeboom L, Lee S, Wieringa F, Groenendaal W, Basile C, van der Sande F, Kooman J. On the potential of wearable bioimpedance for longitudinal fluid monitoring in end-stage kidney disease. Nephrol Dial Transplant 2021; 37:2048-2054. [PMID: 33544863 DOI: 10.1093/ndt/gfab025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 11/12/2022] Open
Abstract
Bioimpedance spectroscopy (BIS) has proven to be a promising non-invasive technique for fluid monitoring in HD patients. While current BIS-based monitoring of pre- and post-dialysis fluid status utilizes benchtop devices, designed for intramural use, advancements in micro-electronics have enabled the development of wearable bioimpedance systems. Wearable systems meanwhile can offer a similar frequency range for current injection as commercially available benchtop devices. This opens opportunities for unobtrusive longitudinal fluid status monitoring, including transcellular fluid shifts, with the ultimate goal of improving fluid management, thereby lowering mortality and improving quality of life for HD patients. Ultra-miniaturized wearable devices can also offer simultaneous acquisition of multiple other parameters, including hemodynamic parameters. Combination of wearable BIS and additional longitudinal multiparametric data may aid in the prevention of both hemodynamic instability as well as fluid overload. The opportunity to also acquire data during interdialytic periods using wearable devices likely will give novel pathophysiological insights and the development of smart (predicting) algorithms could contribute to personalizing dialysis schemes and ultimately to autonomous (nocturnal) home dialysis. This review provides an overview of current research regarding wearable bioimpedance, with special attention to applications in ESKD patients. Furthermore, we present an outlook on the future use of wearable bioimpedance within dialysis practice.
Collapse
Affiliation(s)
- Lucas Lindeboom
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands
| | - Seulki Lee
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands
| | - Fokko Wieringa
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands.,Department of Nephrology, University Medical Center Utrecht, The Netherlands
| | - Willemijn Groenendaal
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands
| | - Carlo Basile
- Division of Nephrology, Miulli General Hospital, Acquaviva delle Fonti, Italy
| | - Frank van der Sande
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jeroen Kooman
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| |
Collapse
|
11
|
Schotman J, van Borren M, Wetzels J, Kloke H, Reichert L, Doorenbos CJ, de Boer H. Impact of diffusion, ultrafiltration, and posture on total body electrical resistance in patients on hemodialysis. J Appl Physiol (1985) 2021; 130:318-324. [PMID: 33211631 DOI: 10.1152/japplphysiol.00688.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Monitoring of hydration in patients on hemodialysis (HD) by currently available bioelectrical impedance analysis (BIA) methods is hampered by limited accuracy. This may be caused by changes in total body electrical resistance (TBER) that are induced by processes other than ultrafiltration (UF). To identify these sources of error, we examined the impact of UF, diffusion, and postural change (PC), separately. Extracellular TBER (TBERe) was measured by bioimpedance spectroscopy every 30 min in 23 patients on HD, for 2 h during diffusion-only (DO), followed by 2-h UF-only (UFO). The impact of PC from upright to semi-recumbent position was assessed by a 2-h TBERe measurement on the day after HD. TBERe increased by 23.5 ± 12.4 Ω (P < 0.001) during DO and by 40.0 ± 16.2 Ω (P < 0.001) during UFO. PC, evaluated on a separate day, was associated with an increase in TBERe of 27.6 ± 26.0 Ω (P < 0.001). TBERe changes during DO were mainly attributed to PC and to a lesser extent to electrolyte exchange. Extrapolation of the data to a conventional 4-h HD session indicates that about 32% of the total increase in TBERe is not related to UF. In conclusion, a significant part of the increase in TBER during HD is not related to UF but can be attributed to other processes such as the effects of PC and diffusion-related electrolyte exchange. These factors have to be taken into account when TBER-guided UF is considered.NEW & NOTEWORTHY Current BIA methods have limited accuracy in patients on HD. This may be related to the incorrect assumption that all changes in total body electrical resistance (TBER) are caused by changes in body water volumes. The present study indicates that two-thirds of the change in TBER during a conventional 4-h HD session can be attributed to fluid extraction, and that the remaining part is caused by other processes such as postural change and electrolyte exchange. This may cause volume prediction errors when not recognized.
Collapse
Affiliation(s)
- Jantine Schotman
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - Marcel van Borren
- Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, The Netherlands
| | - Jack Wetzels
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Heinrich Kloke
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Louis Reichert
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | | | - Hans de Boer
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| |
Collapse
|
12
|
Bachasson D, Ayaz AC, Mosso J, Canal A, Boisserie JM, Araujo ECA, Benveniste O, Reyngoudt H, Marty B, Carlier PG, Hogrel JY. Lean regional muscle volume estimates using explanatory bioelectrical models in healthy subjects and patients with muscle wasting. J Cachexia Sarcopenia Muscle 2021; 12:39-51. [PMID: 33377299 PMCID: PMC7890267 DOI: 10.1002/jcsm.12656] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/22/2020] [Accepted: 11/05/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The availability of non-invasive, accessible, and reliable methods for estimating regional skeletal muscle volume is paramount in conditions involving primary and/or secondary muscle wasting. This work aimed at (i) optimizing serial bioelectrical impedance analysis (SBIA ) by computing a conductivity constant based on quantitative magnetic resonance imaging (MRI) data and (ii) investigating the potential of SBIA for estimating lean regional thigh muscle volume in patients with severe muscle disorders. METHODS Twenty healthy participants with variable body mass index and 20 patients with idiopathic inflammatory myopathies underwent quantitative MRI. Anatomical images and fat fraction maps were acquired in thighs. After manual muscle segmentation, lean thigh muscle volume (lVMRI ) was computed. Subsequently, multifrequency (50 to 350 kHz) serial resistance profiles were acquired between current skin electrodes (i.e. ankle and hand) and voltage electrodes placed on the anterior thigh. In vivo values of the muscle electrical conductivity constant were computed using data from SBIA and MRI gathered in the right thigh of 10 healthy participants. Lean muscle volume (lVBIA ) was derived from SBIA measurements using this newly computed constant. Between-day reproducibility of lVBIA was studied in six healthy participants. RESULTS Electrical conductivity constant values ranged from 0.82 S/m at 50 kHz to 1.16 S/m at 350 kHz. The absolute percentage difference between lVBIA and lVMRI was greater at frequencies >270 kHz (P < 0.0001). The standard error of measurement and the intra-class correlation coefficient for lVBIA computed from measurements performed at 155 kHz (i.e. frequency with minimal difference) against lVMRI were 6.1% and 0.95 in healthy participants and 9.4% and 0.93 in patients, respectively. Between-day reproducibility of lVBIA was as follows: standard error of measurement = 4.6% (95% confidence interval [3.2, 7.8] %), intra-class correlation coefficient = 0.98 (95% confidence interval [0.95, 0.99]). CONCLUSIONS These findings demonstrate a strong agreement of lean muscle volume estimated using SBIA against quantitative MRI in humans, including in patients with severe muscle wasting and fatty degeneration. SBIA shows promises for non-invasive, fast, and accessible estimation and follow-up of lean regional skeletal muscle volume for transversal and longitudinal studies.
Collapse
Affiliation(s)
- Damien Bachasson
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Alper Carras Ayaz
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Jessie Mosso
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Aurélie Canal
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Jean-Marc Boisserie
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Ericky C A Araujo
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology and Inflammation-Immunopathology-Biotherapy Department (I2B), Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, East Paris Neuromuscular Diseases Reference Center, Inserm U974, Sorbonne Université, Paris, France
| | - Harmen Reyngoudt
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Benjamin Marty
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Pierre G Carlier
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Jean-Yves Hogrel
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| |
Collapse
|
13
|
Schneditz D, Sauseng N, Pütün E, Rosenkranz AR, Ribitsch W. Supine equilibration of extracellular fluid in peritoneal dialysis varies with intra-abdominal pressure. Perit Dial Int 2020; 40:477-486. [PMID: 32063186 DOI: 10.1177/0896860819895176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Increased intra-abdominal pressure (PIA) leads to venous congestion in splanchnic and adjoining circulations. The aim is to examine whether PIA in peritoneal dialysis (PD) affects the mobilization of extracellular fluid from the lower body in supine body position. METHODS Patients were studied during a regular peritoneal equilibration test (PET) in supine body position using multifrequency bioimpedance analysis to determine extracellular resistance and absolute volume overload (AVO) in wrist-to-ankle (W2A) as well as in ankle-to-ankle (A2A) configurations. Measurements were taken at baseline (T0) after draining the peritoneal cavity, at T1 shortly after filling with 2 L of standard dialysate, and at T2 before taking the 2 h PET samples. PIA was measured from the column height in the PD catheter. Extracellular resistance in the lower extremities (RL) was taken as half of the A2A resistance. RESULTS Eighteen patients (56 ± 15 years, 76 ± 21 kg, body mass index (BMI) 26.4 ± 7 kg/m2, 13 men) were studied. After having assumed a supine body position for the duration of 17, 77, and 155 min, AVO continuously decreased from 1.6 ± 1.3 (T0) to 1.2 ± 1.5 (T1) and 1.0 ± 1.4 L (T2). RL significantly increased from 238 ± 57 (T0) to 254 ± 62 (T1) and 264 ± 67 Ohm (T2). This increase was negatively correlated to BMI and PIA measured at any time point, but not to net ultrafiltration volume. CONCLUSIONS Orthostatic fluid shifts from the lower limbs may take up to 2 h in supine PD patients, especially with high BMI and PIA because of venous congestion in splanchnic and adjoining circulations.
Collapse
Affiliation(s)
- Daniel Schneditz
- Division of Physiology, Otto Loewi Research Center, 31475Medical University of Graz, Graz, Austria
| | - Notburga Sauseng
- Division of Physiology, Otto Loewi Research Center, 31475Medical University of Graz, Graz, Austria
| | - Ezgi Pütün
- Division of Nephrology, Department of Internal Medicine, 31475Medical University of Graz, Graz, Austria
| | - Alexander R Rosenkranz
- Division of Nephrology, Department of Internal Medicine, 31475Medical University of Graz, Graz, Austria
| | - Werner Ribitsch
- Division of Nephrology, Department of Internal Medicine, 31475Medical University of Graz, Graz, Austria
| |
Collapse
|
14
|
Koelmeyer LA, Ward LC, Dean C, Boyages J. Body Positional Effects on Bioimpedance Spectroscopy Measurements for Lymphedema Assessment of the Arm. Lymphat Res Biol 2020; 18:464-473. [PMID: 32027213 DOI: 10.1089/lrb.2019.0067] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Bioimpedance spectroscopy (BIS) measurements have conventionally been performed using a device that uses gel-backed electrodes with the patient in a supine position. More recently, impedance devices that use stainless steel electrodes with the patient in a standing position have become available. The aim of this study was to assess and compare BIS measurements made in three different body positions using two different impedance devices (lead device and stand-on device) in women with and without arm lymphedema. Methods: A cross-sectional study design was used to recruit two cohorts of women, healthy controls (n = 47) and those who had been diagnosed with breast cancer (n = 53) and were either at risk of (n = 14) or with unilateral arm lymphedema (n = 39). BIS measurements were taken three times in each position for each device. Results: Impedance measurements were reliably made using either a lead or stand-on device with a coefficient of variation being 0.6% or lower. Absolute impedance measurements for the stand-on device were larger than the comparable lead device values due to the difference in electrode position, but were highly correlated (r = 0.92, p < 0.0001). Interarm impedance ratios and L-Dex scores were slightly (3.1% equivalence), but significantly different. Conclusion: The findings support impedance measurements being made reliably using either the lead or stand-on device, representing supine and upright measurement positions, respectively. Data between devices were, however, not directly interchangeable.
Collapse
Affiliation(s)
- Louise A Koelmeyer
- Australian Lymphoedema Education, Research and Treatment Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Australia
| | - Catherine Dean
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - John Boyages
- Australian Lymphoedema Education, Research and Treatment Program, Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| |
Collapse
|
15
|
Ogawa R, Baidillah MR, Akita S, Takei M. Investigation of Physiological Swelling on Conductivity Distribution in Lower Leg Subcutaneous Tissue by Electrical Impedance Tomography. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2020; 11:19-25. [PMID: 33584899 PMCID: PMC7531098 DOI: 10.2478/joeb-2020-0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Indexed: 06/12/2023]
Abstract
There is a strong need for a non-invasive measurement technique that is capable of accurately identifying the physiological condition change or heterogeneity of subcutaneous adipose tissue (SAT) by localizing the abnormalities within the compartment. This paper aims to investigate the feasibility of Electrical Impedance Tomography (EIT) to assess the interstitial fluid in subcutaneous adipose tissue as an enhancement method of bioelectrical impedance spectroscopy (BIS). Here, we demonstrate the preliminary result of EIT with a wearable 16 electrodes sensor. The image-based reference EIT with fat weighted threshold method is proposed. In order to evaluate the performance of our novel method, a physiological swelling experiment is conducted, and Multi-Frequency Bioelectrical Impedance Analysis (MFBIA) is also applied as a comparison with EIT results. The experimental results showed that the proposed method was able to distinguish the physiological swelling condition and effectively to remove the unexpected background noise. Furthermore, the conductivity variation in the subcutaneous layer had a good correlation with extracellular water volume change from MFBIA data; the correlation coefficient R2 = 0.927. It is concluded that the proposed method provides a significant prospect for SAT assessment.
Collapse
Affiliation(s)
- R. Ogawa
- Graduate School of Science & Eng., Dept. Mechanical Eng., Chiba University, Chiba, Japan
| | - M. R. Baidillah
- Graduate School of Science & Eng., Dept. Mechanical Eng., Chiba University, Chiba, Japan
| | - S. Akita
- Graduate School of Medicine, Dept. Reconstructive & Aesthetic Surgery, Chiba University, Chiba, Japan
| | - M. Takei
- Graduate School of Science & Eng., Dept. Mechanical Eng., Chiba University, Chiba, Japan
| |
Collapse
|
16
|
Cross-sectional and longitudinal agreement between two multifrequency bioimpedance devices for resistance, reactance, and phase angle values. Eur J Clin Nutr 2019; 74:900-911. [PMID: 31455876 DOI: 10.1038/s41430-019-0496-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 01/29/2023]
|
17
|
Timmer CY, Bosman J, Geertzen JHB, Dijkstra PU. Variation in Measurement Results Using Bioimpedance Spectroscopy to Determine Extracellular Fluid of Upper Extremity. Lymphat Res Biol 2019; 18:110-115. [PMID: 31429626 DOI: 10.1089/lrb.2018.0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The L-Dex U400 is a recently developed measurement device to aid in the clinical assessment of unilateral lymphedema. Until now, little is known about variation in measurement results of the L-Dex U400. The aim of this study was to determine variation in measurement results in determining extracellular fluid of the arm with the L-Dex U400 under different measurement conditions on 2 days and to determine the reliability of these measurements in healthy subjects. Methods and Results: Thirty participants were included. Participants were measured on 2 days, 2 weeks apart. Each day they were measured six times, 1st basic measurement, 2nd after a 10-minute rest period, 3rd second observer, 4th after drinking 200 mL of coffee and rest for 30 minutes on the examination couch, 5th after 30 minutes of cycling on an exercise bike at 50 W and 50-60 rounds per minute, and 6th after a 10-minute rest period. The variance due to participants was 68% of the total variance and 32% was error variance. Lin's concordance coefficient (CCC), a reliability measure, ranged from 0.935 (first day, 1st and 2nd measurement of observer 1) to 0.517 (first and second day after a 10-minute rest period after cycling). In two CCCs, the lower limits of the 95% confidence interval were higher than 0.750. Repeatability coefficient was smallest for the basic observations on day 2 (4.6) and largest after cycling (8.0). Conclusions: Clinical decision-making based on L-Dex U400 measurements should be regarded with caution because of moderate reliability.
Collapse
Affiliation(s)
- Carola Y Timmer
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joyce Bosman
- Physical Therapy Practice Lymfology and Oncology Physical therapy LOF, Groningen, The Netherlands
| | - Jan H B Geertzen
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
18
|
Ismail AH, Schlieper G, Walter M, Floege J, Leonhardt S. Knee-to-knee Bioimpedance Measurements to Monitor Changes in Extracellular Fluid in Haemodynamic-unstable Patients During Dialysis. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2019; 10:55-62. [PMID: 33584883 PMCID: PMC7531213 DOI: 10.2478/joeb-2019-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Indexed: 06/12/2023]
Abstract
The feasibility of bioimpedance spectroscopy (BIS) techniques for monitoring intradialytic changes in body fluids is advancing. The aim of this study was to compare the knee-to-knee (kkBIS) with the traditional whole-body (whBIS) with respect to continuous assessment of fluid volume status in hemodialysis patients. Twenty patients divided into two groups, hemodynamically stable and unstable, were recruited. Bioimpedance data from two different electrodes configurations (hand-to-foot and knee-to-knee) were collected and retrospectively analysed. A good correlation between the two methods with respect to changes in extracellular resistance (Re) and Re normalized for ultrafiltration volume (ΔRe/UFV) with p < 0.001 was observed. The relationship between relative change (%) in ΔRe and that in patient weight was most notable with kkBIS (4.82 ± 3.31 %/kg) in comparison to whBIS (3.69 ± 2.90 %/kg) in unstable patients. Furthermore, results based on kkBIS showed a reduced ability of the thigh compartments to keep up with the volume changes in the trunk for unstable patients. kkBIS provided a comparable sensitivity to whBIS even in patients at risk of intradialytic hypotension while avoiding the need for the complex implementation imposed by whBIS or other configurations.
Collapse
Affiliation(s)
- Abdul Hamid Ismail
- Chair for Medical Information Technology, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, Aachen, Germany
| | - Georg Schlieper
- Department of Nephrology and Immunology (Medical Clinic II), RWTH Aachen University Hospital, Pauwelsstr. 30, Aachen, Germany
| | - Marian Walter
- Chair for Medical Information Technology, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, Aachen, Germany
| | - Jürgen Floege
- Department of Nephrology and Immunology (Medical Clinic II), RWTH Aachen University Hospital, Pauwelsstr. 30, Aachen, Germany
| | - Steffen Leonhardt
- Chair for Medical Information Technology, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, Aachen, Germany
| |
Collapse
|
19
|
Thurlow S, Taylor-Covill G, Sahota P, Oldroyd B, Hind K. Effects of procedure, upright equilibrium time, sex and BMI on the precision of body fluid measurements using bioelectrical impedance analysis. Eur J Clin Nutr 2017; 72:148-153. [PMID: 28722029 DOI: 10.1038/ejcn.2017.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/30/2017] [Accepted: 06/12/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Extensive work has addressed the validity of bioimpedance (BIA) measurements and the effect of posture on fluid homeostasis. However, limited research has investigated effects of subject preparation. This study aimed to determine the precision of total body water (TBW) and extracellular water (ECW) measurements using a stand-on multifrequency BIA (MFBIA seca mBCA 514/515), in three pre-test procedures: supine, sitting, and following walking, with specific reference to the influence of sex and body mass index (BMI). SUBJECTS/METHODS Fifty three healthy, ambulatory men (n=26, age:32.5±9.4 years) and women (n=27, age:35.2±10.3 years) received repeat MFBIA measurements (six measurements from 0 to 15 min). Agreement and precision were evaluated for each condition and paired time points. RESULTS Significant TBW sex differences from supine posture were observed for walking (females) and sitting (males) postures. For BMI (⩽24.9 kg m-2) significant TBW differences from supine were observed for both sitting and walking and significant ECW differences from sitting were also observed with both supine and walking. There was no significant effect of sex or BMI (⩾25.0 kg m-2) on ECW measures. Irrespective of sex or BMI, there was close agreement in TBW and ECW precision over the three protocols. CONCLUSIONS Practitioners can have confidence in the precision of TBW and ECW measurements within a 15 min time period and pre-testing conditions (supine, sitting or walking) in healthy subjects, though must be cautious in assessments when pre-test postures change. Further research to examine the impact of pre-testing procedures on stand-on MFBIA BIA measurements, including subjects with fluid disturbance, is warranted.
Collapse
Affiliation(s)
- S Thurlow
- Bone and Body Composition Research Group, Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - G Taylor-Covill
- Faculty of Health and Social Sciences, Leeds Beckett University, City Campus, UK
| | - P Sahota
- Faculty of Health and Social Sciences, Leeds Beckett University, City Campus, UK
| | - B Oldroyd
- Bone and Body Composition Research Group, Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - K Hind
- Bone and Body Composition Research Group, Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| |
Collapse
|
20
|
Saporito S, Dovancescu S, Herold IHF, van den Bosch HCM, van Assen HC, Aarts RM, Korsten HHM, Mischi M. Comparison of cardiac magnetic resonance imaging and bio-impedance spectroscopy for the assessment of fluid displacement induced by external leg compression. Physiol Meas 2016; 38:15-32. [DOI: 10.1088/1361-6579/38/1/15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
21
|
Montgomery LD, Montgomery RW, Gerth WA, Lew SQ, Klein MD, Stewart JM, Medow MS, Velasquez MT. Bioimpedance monitoring of cellular hydration during hemodialysis therapy. Hemodial Int 2016; 21:575-584. [PMID: 27860119 DOI: 10.1111/hdi.12511] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction The aim of this paper is to describe and demonstrate how a new bioimpedance analytical procedure can be used to monitor cellular hydration of End Stage Renal Disease (ESRD) patients during hemodialysis (HD). Methods A tetra-polar bioimpedance spectroscope (BIS), (UFI Inc., Morro Bay, CA), was used to measure the tissue resistance and reactance of the calf of 17 ESRD patients at 40 discrete frequencies once a minute during dialysis treatment. These measurements were then used to derive intracellular, interstitial, and intravascular compartment volume changes during dialysis. Findings The mean (± SD) extracellular resistance increased during dialysis from 92.4 ± 3.5 to 117.7 ± 5.8 Ohms. While the mean intracellular resistance decreased from 413.5 ± 11.7 to 348.5 ± 8.2 Ohms. It was calculated from these data that the mean intravascular volume fell 9.5%; interstitial volume fell 33.4%; and intracellular volume gained 20.3%. Discussion These results suggest that an extensive fluid shift into the cells may take place during HD. The present research may contribute to a better understanding of how factors that influence fluid redistribution may affect an ESRD patient during dialysis. In light of this finding, it is concluded that the rate of vascular refill is jointly determined with the rate of "cellular refill" and the transfer of fluid from the intertitial compartment into the intravascular space.
Collapse
Affiliation(s)
| | | | | | - Susie Q Lew
- George Washington University Medical Center, Washington, DC, USA
| | | | | | | | | |
Collapse
|
22
|
Charra B, Jean G, Hurot JM, Terrat JC, Vanel T, VoVan C, Maazoun F, Chazot C. Clinical Determination of Dry Body Weight. Hemodial Int 2016; 5:42-50. [DOI: 10.1111/hdi.2001.5.1.42] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Earthman CP. Body Composition Tools for Assessment of Adult Malnutrition at the Bedside: A Tutorial on Research Considerations and Clinical Applications. JPEN J Parenter Enteral Nutr 2016; 39:787-822. [PMID: 26287016 DOI: 10.1177/0148607115595227] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Because of the key role played by the body's lean tissue reserves (of which skeletal muscle is a major component) in the response to injury and illness, its maintenance is of central importance to nutrition status. With the recent development of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition diagnostic framework for malnutrition, the loss of muscle mass has been recognized as one of the defining criteria. Objective methods to evaluate muscle loss in individuals with acute and chronic illness are needed. Bioimpedance and ultrasound techniques are currently the best options for the clinical setting; however, additional research is needed to investigate how best to optimize measurements and minimize error and to establish if these techniques (and which specific approaches) can uniquely contribute to the assessment of malnutrition, beyond more subjective evaluation methods. In this tutorial, key concepts and statistical methods used in the validation of bedside methods to assess lean tissue compartments are discussed. Body composition assessment methods that are most widely available for practice and research in the clinical setting are presented, and clinical cases are used to illustrate how the clinician might use bioimpedance and/or ultrasound as a tool to assess nutrition status at the bedside. Future research needs regarding malnutrition assessment are identified.
Collapse
Affiliation(s)
- Carrie P Earthman
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St Paul, Minnesota
| |
Collapse
|
24
|
Montalibet A, Arkouche W, Bogonez Franco P, Bonnet S, Clarion A, Delhomme G, Gehin C, Gharbi S, Guillemaud R, Jallon P, Massot B, Pham P, Ribbe-Cornet E, McAdams E. The Complicating Effects of Patient Limb Position on the Development of a Localised Impedimetric-Based Hydrational Index for the Remote Monitoring of Home-Based Dialysis Patients. Ing Rech Biomed 2016. [DOI: 10.1016/j.irbm.2016.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
25
|
van Zanten M, Piller N, Ward LC. Inter-Changeability of Impedance Devices for Lymphedema Assessment. Lymphat Res Biol 2015; 14:88-94. [PMID: 26574711 DOI: 10.1089/lrb.2015.0026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Impedance technology is a popular technique for the early detection of lymphedema. The preferred approach is to use bioimpedance spectroscopy (BIS), with measurements being made with the subject lying supine, although attempts have been made to use single or multiple frequency impedance measurements obtained while the subject is standing. The aim of the present study was to determine the equivalence of these different approaches. Impedance measurements of the individual limbs of 37 healthy individuals were determined using both a stand-on, multi-frequency impedance device and a supine impedance spectroscopy instrument. Significant differences were found between the instruments in both absolute impedance values and, importantly, inter-limb impedance ratios. Since impedance ratios in healthy individuals provide the reference standard for detection of lymphedema, these data indicate that the methods are not interchangeable. Consideration of the errors associated with each method indicates that the BIS remains the preferred method for lymphedema detection.
Collapse
Affiliation(s)
- Malou van Zanten
- 1 Lymphoedema Research Unit, Department of Surgery, School of Medicine, Flinders University , South Australia, Australia
| | - Neil Piller
- 1 Lymphoedema Research Unit, Department of Surgery, School of Medicine, Flinders University , South Australia, Australia
| | - Leigh C Ward
- 2 School Chemistry and Molecular Biosciences, The University of Queensland , Queensland, Australia
| |
Collapse
|
26
|
Oldroyd B, Robinson M, Lindley E, Rhodes L, Hind K. Resonant cavity perturbation: a promising new method for the assessment of total body water in children. Physiol Meas 2015; 36:2503-17. [PMID: 26535491 DOI: 10.1088/0967-3334/36/12/2503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The accurate measurement of total body water (TBW) in children has important clinical and nutritional applications. Resonant cavity perturbation (RCP) is a new method for estimating TBW. This method measures the dielectric properties of the body which are related to body water. For RCP measurements, each subject lay supine on a bed inside a screened room which acts as a resonant cavity. A network analyser measures the frequencies of two low-order cavity resonances of the room, with electric-field vectors that were respectively vertical and horizontal, the resonant frequency shifts relative to the empty room are then derived. These frequency shifts correlates with TBW. The aims of this present study were to (a) develop TBW(RCP) predictive equations for children using TBWdil as the criterion method, (b) cross-validate the derived equations, (c) determine precision of the TBW(RCP) method, and (d) compare the criterion method TBWdil with three methods of estimating TBW: RCP, MFBIS and anthropometry.Predictive equations, independent of sex, were developed with linear regression in a group of 36 children. The relationship between combined RCP frequency shifts and TBWdilution had an r2 = 0.90 and standard error of the estimate (SEE) =1.42 kg. Multiple regression analysis, that included a term for body mass index, only had a small effect on r2 = 0.93 and SEE = 1.25 kg. In vivo TBW precision for the vertical, horizontal and combined frequency modes ranged from 0.7 to 3.4%. Bland-Altman analysis indicated close agreement between the criterion method TBWdil and the three other methods of TBW estimation. Mean differences were TBW(RCP(2)) = 0.01 ± /- 1.34 kg, TBW(MFBIS) = 0.45 ± /- 1.35 kg, TBWAnthropometry = 0.29 ± /- 1.29 kg.Currently the RCP method does not significantly improve the prediction of TBW compared to MFBIS and anthropometry in this initial study. However the derived equation was independent of sex and body size had only a small effect.
Collapse
Affiliation(s)
- Brian Oldroyd
- Carnegie Research Institute, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK
| | | | | | | | | |
Collapse
|
27
|
Yaguiyan-Colliard L, Daumas C, Nguyen P, Grandjean D, Cardot P, Priymenko N, Roux F. Evaluation of total body water in canine breeds by single-frequency bioelectrical impedance analysis method: specific equations are needed for accuracy. BMC Res Notes 2015; 8:336. [PMID: 26245326 PMCID: PMC4526165 DOI: 10.1186/s13104-015-1298-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 07/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Equations based on single-frequency bioelectrical impedance analysis at 50 kHz for determination of total body water content (TBW) have been previously validated in healthy non-sedated beagle dogs. We investigated whether these equations are predictive of TBW in various canine breeds by comparing the results of these equations with TBW values evaluated directly by deuterium oxide (D2O) dilution. Methods Total body water content of 13 healthy adult pet dogs of various breeds was determined directly using D2O dilution and indirectly using previous equations based on values obtained with a portable bioelectric impedance device. Paired Student’s t-tests were used to compare TBW obtained by single-frequency bioelectrical impedance analysis and D2O dilution. A p-value of <0.05 was considered statistically significant for all analyses. Results Significant differences were observed between TBW determined by the reference method and the values obtained with both predictive equations. Conclusions The proposed equations including single-frequency bioelectrical impedance analysis parameters validated at 50 kHz in healthy adult beagles need to be modified including morphological parameters such as body size and shape in a first approach. As in humans, morphological-specific equations have to be developed and validated.
Collapse
Affiliation(s)
- Laurence Yaguiyan-Colliard
- Breeding and Sport Medicine Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 avenue du Général de Gaulle, Maisons-Alfort, 94704, France.
| | - Caroline Daumas
- Nutrition and Endocrinology Unit, École Nationale Vétérinaire de Nantes (ONIRIS), Atlanpole La Chantrerie, route de Gachet, CS 40706, 44307, Nantes Cedex 3, France.
| | - Patrick Nguyen
- Nutrition and Endocrinology Unit, École Nationale Vétérinaire de Nantes (ONIRIS), Atlanpole La Chantrerie, route de Gachet, CS 40706, 44307, Nantes Cedex 3, France.
| | - Dominique Grandjean
- Breeding and Sport Medicine Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 avenue du Général de Gaulle, Maisons-Alfort, 94704, France.
| | - Philippe Cardot
- Experimental and Clinical Respiratory Neurophysiology Unit, Faculté de Médecine Pierre and Marie Curie, Université Pierre et Marie Curie, UMRS-1158, 91 Boulevard de l'Hôpital, 75634, Paris Cedex 13, France.
| | - Nathalie Priymenko
- École Nationale Vétérinaire UMR1331 Toxalim INRA/INP/UPS-ENVT, BP 87614, 31076, Toulouse Cedex 3, France.
| | - Françoise Roux
- Intensive Care Medicine Unit, École Nationale Vétérinaire de Nantes (ONIRIS), Atlanpole La Chantrerie, route de Gachet, CS 40706, 44307, Nantes Cedex 3, France.
| |
Collapse
|
28
|
Kotnik KZ, Robič T, Golja P. Which method to use for a fast assessment of body fat percentage? Physiol Meas 2015; 36:1453-68. [PMID: 26020697 DOI: 10.1088/0967-3334/36/7/1453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Body position affects body water distribution and in turn the accuracy of bioelectrical impedance analysis (BIA), which may consequently distort conclusions about an individual's body composition.We compared body fat percentage (BFP) obtained with leg-to-leg-BIA (LL) and hand-to-leg-BIA (HL) with the reference values.The BFPs of 97 individuals were determined with an LL- (Tanita TBF 215GS, Japan) and HL- (Akern, STA/BIA, Italy) BIA-analyser and with reference skinfold thickness (SF) measurements. Each subject was measured upright with the LL-analyser, and upright and supine with the HL-analyser, both before and after 20 min of supine rest. The one-way ANOVA for repeated measures (HL-BIA), Student's t-test (LL-BIA), intraclass correlation coefficients, and Bland-Altman's plots were used for statistical analysis.BFPs determined with HL/LL BIA in upright/supine positions differ significantly. Compared to the SF method, HL-BIA mostly overestimates, while LL-BIA mostly underestimates BFP. Agreement between anthropometrically determined BFP and HL/LL-BIA determined BFP is better with HL for both sexes, and generally better in females than males.HL-BIA-determined estimates of BFP are more similar to reference values than LL-BIA. However, for both BIA methods, BIA-determined estimates of BFP are significantly affected by body position. Consequently, different BIA methods will classify approximately one fifth of subjects into the erroneous body-fat-content category, which calls for urgent standardization.
Collapse
Affiliation(s)
- Katja Zdešar Kotnik
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Vecna pot 111, SI-1000 Ljubljana, Slovenia
| | | | | |
Collapse
|
29
|
Kose SB, Hür E, Taskin H, Bicak S, Duman S. Volume status effected by gravity and body fluid shifts: new protocol for bioimpedance measurements. Ren Fail 2014; 36:1587-8. [DOI: 10.3109/0886022x.2014.962422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Khalil SF, Mohktar MS, Ibrahim F. The theory and fundamentals of bioimpedance analysis in clinical status monitoring and diagnosis of diseases. SENSORS 2014; 14:10895-928. [PMID: 24949644 PMCID: PMC4118362 DOI: 10.3390/s140610895] [Citation(s) in RCA: 276] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/03/2014] [Accepted: 06/04/2014] [Indexed: 12/13/2022]
Abstract
Bioimpedance analysis is a noninvasive, low cost and a commonly used approach for body composition measurements and assessment of clinical condition. There are a variety of methods applied for interpretation of measured bioimpedance data and a wide range of utilizations of bioimpedance in body composition estimation and evaluation of clinical status. This paper reviews the main concepts of bioimpedance measurement techniques including the frequency based, the allocation based, bioimpedance vector analysis and the real time bioimpedance analysis systems. Commonly used prediction equations for body composition assessment and influence of anthropometric measurements, gender, ethnic groups, postures, measurements protocols and electrode artifacts in estimated values are also discussed. In addition, this paper also contributes to the deliberations of bioimpedance analysis assessment of abnormal loss in lean body mass and unbalanced shift in body fluids and to the summary of diagnostic usage in different kinds of conditions such as cardiac, pulmonary, renal, and neural and infection diseases.
Collapse
Affiliation(s)
- Sami F Khalil
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Mas S Mohktar
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Fatimah Ibrahim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| |
Collapse
|
31
|
Kagawa M, Wishart C, Hills AP. Influence of posture and frequency modes in total body water estimation using bioelectrical impedance spectroscopy in boys and adult males. Nutrients 2014; 6:1886-98. [PMID: 24803099 PMCID: PMC4042563 DOI: 10.3390/nu6051886] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/16/2014] [Accepted: 04/26/2014] [Indexed: 01/10/2023] Open
Abstract
The aim of the study was to examine differences in total body water (TBW) measured using single-frequency (SF) and multi-frequency (MF) modes of bioelectrical impedance spectroscopy (BIS) in children and adults measured in different postures using the deuterium (2H) dilution technique as the reference. Twenty-three boys and 26 adult males underwent assessment of TBW using the dilution technique and BIS measured in supine and standing positions using two frequencies of the SF mode (50 kHz and 100 kHz) and the MF mode. While TBW estimated from the MF mode was comparable, extra-cellular fluid (ECF) and intra-cellular fluid (ICF) values differed significantly (p < 0.01) between the different postures in both groups. In addition, while estimated TBW in adult males using the MF mode was significantly (p < 0.01) greater than the result from the dilution technique, TBW estimated using the SF mode and prediction equation was significantly (p < 0.01) lower in boys. Measurement posture may not affect estimation of TBW in boys and adult males, however, body fluid shifts may still occur. In addition, technical factors, including selection of prediction equation, may be important when TBW is estimated from measured impedance.
Collapse
Affiliation(s)
- Masaharu Kagawa
- Institute of Nutrition Sciences, Kagawa Nutrition University, Saitama 350-0288, Japan.
| | - Connie Wishart
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland 4059, Australia.
| | - Andrew P Hills
- Mater Research Institute, the University of Queensland and Griffith Health Institute, Griffith University, Queensland 4101, Australia.
| |
Collapse
|
32
|
Hyun SH, Choi JY, Cho JH, Park SH, Kim CD, Kim YL. Assessment of fluid and nutritional status using multifrequency bioelectrical impedance analysis in peritoneal dialysis patients. Blood Purif 2014; 37:152-62. [PMID: 24777057 DOI: 10.1159/000360272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 02/02/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The purpose of this study was to evaluate the clinical usefulness and relevance of bioelectrical impedance analysis (BIA) for assessing the fluid and nutritional status in peritoneal dialysis (PD) patients. METHODS Statistical analyses between various measures of fluid and nutritional status were performed in 106 cases of 64 patients. RESULTS Extracellular fluid/total body water (ECF/TBW) was correlated with systolic blood pressure, extremity edema, and antihypertensive medications (p = 0.042, p < 0.001, and p = 0.029, respectively). Body cell mass (BCM)/height(2) was correlated with SGA rating and PCR (p < 0.001 and p = 0.002, respectively). ECF/TBW and BCM/height(2) significantly predicted extremity edema (p < 0.001) and SGA rating (p = 0.001), respectively. ROC analysis yielded an ECF/TBW cut-off of 0.36 and a BCM/height(2) cut-off of 11.23. When the BCM/height(2) cut-off of 11.23 was applied to subclinical patients (SGA score ≥6), a significant difference in SGA rating was detected in subgroups (p = 0.010). CONCLUSION BIA yields useful and relevant information about hydration and nutritional status in PD patients.
Collapse
Affiliation(s)
- Seung-Hyea Hyun
- Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | | | | | | | | | | |
Collapse
|
33
|
Abbas SR, Zhu F, Kaysen GA, Kotanko P, Levin NW. Effect of change in fluid distribution in segments in hemodialysis patients at different ultrafiltration rates on accuracy of whole body bioimpedance measurement. J Appl Physiol (1985) 2014; 116:1382-9. [PMID: 24674858 DOI: 10.1152/japplphysiol.01361.2013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study explored divergence (error) between ultrafiltration volumes (UFV) and intradialytic changes in extracellular volume (ΔECV) in hemodialysis (HD) patients measured by whole body (wBIS) and sum of segmental bioimpedance spectroscopy (sBIS). The primary aim of the study was to evaluate the effect of different ultrafiltration rates (UFR) on error of estimation of ΔECV by changes in their distribution in body segments (arm, trunk, and leg). Forty-four HD patients (26 men, age 63.5 ± 14.3 yr) were studied twice in the same week following high and low UFR treatments. ΔECV and distributions (segmental ΔECV/Σsegmental ΔECV, %) in arm, trunk, and leg were measured. ΔECV by wBIS underestimated UFV (0.58 ± 0.43 in high vs. 0.36 ± 0.5 liters at low UFR; P < 0.001, respectively); however, using sBIS no significant difference between UFV and ΔECV was present. Divergence using wBIS but not sBIS correlated positively with UFR. ΔECV distribution in trunk and leg at high UFR (44.1 ± 8.3, 47.2 ± 8.5, %) differed significantly (P < 0.01) from low UFR (36 ± 15.7, 53.8 ± 14.7) respectively, but in arm did not differ between UFR. Primary sources of whole body resistance are arms and legs. Due to different cross-sectional areas between trunk and limbs, wBIS is insensitive to detection of changes in trunk volume. At higher UFR, plasma water was rapidly and largely removed from the trunk but with only a small change in whole body resistance. As a result, accuracy of estimation of ECV by wBIS is further decreased by high UFR, while sBIS remains accurate using separate measurements of segmental volumes.
Collapse
Affiliation(s)
| | - Fansan Zhu
- Renal Research Institute, New York, New York; and
| | - George A Kaysen
- Renal Research Institute, New York, New York; and Department of Medicine Division of Nephrology, Department of Biochemistry and Molecular Medicine, University of California, Davis, California
| | | | | |
Collapse
|
34
|
Matthie JR. Bioimpedance measurements of human body composition: critical analysis and outlook. Expert Rev Med Devices 2014; 5:239-61. [DOI: 10.1586/17434440.5.2.239] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
35
|
Gibson AL, Beam JR, Alencar MK, Zuhl MN, Mermier CM. Time course of supine and standing shifts in total body, intracellular and extracellular water for a sample of healthy adults. Eur J Clin Nutr 2014; 69:14-9. [DOI: 10.1038/ejcn.2013.269] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 10/25/2013] [Accepted: 11/12/2013] [Indexed: 11/09/2022]
|
36
|
González-Correa CH, Caicedo-Eraso JC. Bioelectrical impedance analysis (BIA): a proposal for standardization of the classical method in adults. ACTA ACUST UNITED AC 2012. [DOI: 10.1088/1742-6596/407/1/012018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
37
|
A novel bioimpedance technique to monitor fluid volume state during hemodialysis treatment. ASAIO J 2010; 56:215-20. [PMID: 20404719 DOI: 10.1097/mat.0b013e3181d89160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Bioimpedance spectroscopy is a potential candidate for monitoring of body fluids during dialysis. In this article, the suitability of knee-to-knee (KK) as an alternative to wrist-to-ankle (WA) bioimpedance spectroscopy measurements during dialysis is evaluated. Measurements on eight patients (22 dialysis sessions) showed a good correlation between the change in extracellular resistance (Re) in KK and WA measurements. A deeper analysis indicated that the change in Re normalized for ultrafiltrated volume [DeltaRe/UFV (%/L)] depends on the characteristics of the patient: clinically stable patients [with a presumed lower extracellular fluid - total body volume (VB) relationship] show a higher DeltaRe/UFV (%/L) mean +/- standard deviation (WA: 8.90 +/- 1.9 and KK: 8.29 +/- 2.2) than clinically unstable patients with pitting peripheral edema (WA: 2.10 +/- 0.8 and KK: 2.07 +/- 0.2). Simulations based on bioimpedance equations considering Hanai theory confirm the results. The KK method, especially in combination with proper use of the introduced DeltaRe/UFV (%/L) normalization could possibly offer new options for comfortable online monitoring and the evaluation of fluid volume state during dialysis.
Collapse
|
38
|
Buendia R, Seoane F, Gil-Pita R. A novel approach for removing the hook effect artefact from Electrical Bioimpedance spectroscopy measurements. ACTA ACUST UNITED AC 2010. [DOI: 10.1088/1742-6596/224/1/012126] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
39
|
Nagai M, Komiya H, Mori Y, Ohta T, Kasahara Y, Ikeda Y. Estimating visceral fat area by multifrequency bioelectrical impedance. Diabetes Care 2010; 33:1077-9. [PMID: 20150289 PMCID: PMC2858179 DOI: 10.2337/dc09-1099] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We developed a new method of estimating visceral fat area (VFA) using multifrequency bioelectrical impedance (BI). RESEARCH DESIGN AND METHODS We considered abdominal composition as a parallel circuit model composed of VFA and subcutaneous fat area and calculated the impedance of VFA (IP(VFA)) from this model. The methods were tested against measures of VFA by computed tomography (CT). Multiple regression analysis was performed on 103 participants to estimate VFA. We cross-validated the regression equation against CT-measured VFA in 30 additional participants. RESULTS The regression equation was VFA = 3.57 x sagittal abdominal diameter + 311.97 x waist-to-height ratio + 0.71 x age + 23.93 x sex + 1.57 x IP(VFA) (250 kHz) - 174.35 (r = 0.904, P < 0.01). We observed a strong correlation by cross-validation (r = 0.905). CONCLUSIONS Our method using BI is a simple and convenient method for accurately estimating VFA.
Collapse
Affiliation(s)
- Masato Nagai
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | | | | | | | | | | |
Collapse
|
40
|
Medrano G, Eitner F, Walter M, Leonhardt S. Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements. Med Biol Eng Comput 2010; 48:531-41. [PMID: 20405231 DOI: 10.1007/s11517-010-0602-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Accepted: 03/31/2010] [Indexed: 10/19/2022]
Abstract
Bioimpedance spectroscopy (BIS) is suitable for continuous monitoring of body water content. The combination of body posture and time is a well-known source of error, which limits the accuracy and therapeutic validity of BIS measurements. This study evaluates a model-based correction as a possible solution. For this purpose, an 11-cylinder model representing body impedance distribution is used. Each cylinder contains a nonlinear two-pool model to describe fluid redistribution due to changing body position and its influence on segmental and hand-to-foot (HF) bioimpedance measurements. A model-based correction of segmental (thigh) and HF measurements (Xitron Hydra 4200) in nine healthy human subjects (following a sequence of 7 min supine, 20 min standing, 40 min supine) has been evaluated. The model-based compensation algorithm represents a compromise between accuracy and simplicity, and reduces the influence of changes in body position on the measured extracellular resistance and extracellular fluid by up to 75 and 70%, respectively.
Collapse
Affiliation(s)
- Guillermo Medrano
- Philips Chair for Medical Information Technology (MedIT), Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074, Aachen, Germany.
| | | | | | | |
Collapse
|
41
|
Lee SW, Kim DY, Lee SH, Cho HC, Kwon SH, Song JH, Kim MJ. New method of predicting dry weight using bioelectrical impedance analysis in haemodialysis patients. Nephrology (Carlton) 2009; 14:705-11. [PMID: 20025677 DOI: 10.1111/j.1440-1797.2009.01123.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM There were significant differences in the slopes of the ultrafiltration (UF) amount removed during haemodialysis (HD) sessions versus the percentage change in the extracellular fluid/total body water ratio for the right lower extremity (ECF/TBW(right leg)) plot in normohydrated (NH) and overhydrated states. The purpose of this study was to develop and validate a method for predicting dry weight (DW) using these results. METHODS It was hypothesized that for patients to become NH, the slope of the UF amount versus the percentage changes in ECF/TBW(right leg) plot should be same as that of NH patients and a method for predicting DW was developed. To validate the accuracy of this method, the ECF/TBW(right leg) was measured by eight-point tactile-electrode bioelectrical impedance analysis before and after HD in 17 newly enrolled NH patients. Using the current DW (cDW) of subjects as a reference, we compared the accuracies of pDW1 (our devised method) and pDW2 (the normovolaemia/hypervolaemia slope method). RESULTS The mean cDW, pDW1 and pDW2 values were 56.8 +/- 7.9, 56.4 +/- 7.7 and 56.3 +/- 8.0 kg, respectively. No significant differences existed between cDW, pDW1 and pDW2. pDW1 had a lower root mean square error than pDW2 (1.12 vs 1.69). On the Bland-Altman plot, differences between pDW1 and cDW were closer to zero than between pDW2 and cDW. CONCLUSION A new method was developed of predicting the DW using the relationship between the UF amount and the percentage change in the ECF/TBW ratio of the lower extremities after HD. The devised method appears to be as accurate as the normovolaemia/hypervolaemia slope method.
Collapse
Affiliation(s)
- Seoung Woo Lee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Kidney Disease Research Group, Inha University College of Medicine, Incheon, Korea
| | | | | | | | | | | | | |
Collapse
|
42
|
Carter M, Zhu F, Kotanko P, Kuhlmann M, Ramirez L, Heymsfield SB, Handelman G, Levin NW. Assessment of body composition in dialysis patients by arm bioimpedance compared to MRI and 40K measurements. Blood Purif 2009; 27:330-7. [PMID: 19270452 DOI: 10.1159/000207200] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 11/04/2008] [Indexed: 01/21/2023]
Abstract
This study used multi-frequency bioimpedance spectroscopy (BIS) of the arm and whole body to estimate muscle mass (MM) and subcutaneous adipose tissue (SAT) in 31 hemodialysis (HD) patients comparing these results with magnetic resonance imaging (MRI) and body potassium ((40)K) as gold standards. Total body and arm MM (MM(MRI)) and SAT (SAT(MRI)) were measured by MRI. All measurements were made before dialysis treatment. Regression models with the arm (aBIS) and whole body (wBIS) resistances were established. Correlations between gold standards and the BIS model were high for the arm SAT (r(2) = 0.93, standard error of estimate (SEE) = 3.6 kg), and whole body SAT (r(2) = 0.92, SEE = 3.5 kg), and for arm MM (r(2) = 0.84, SEE = 2.28 kg) and whole body MM (r(2) = 0.86, SEE = 2.28 kg). Total body MM and SAT can be accurately predicted by arm BIS models with advantages of convenience and portability, and it should be useful to assess nutritional status in HD patients.
Collapse
Affiliation(s)
- M Carter
- Renal Research Institute, Yorkville Dialysis Center, 1555 3rd Avenue #218, New York, NY 10128, USA
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Zhu F, Leonard EF, Levin NW. Extracellular fluid redistribution during hemodialysis: bioimpedance measurement and model. Physiol Meas 2008; 29:S491-501. [DOI: 10.1088/0967-3334/29/6/s41] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
44
|
Freiberger M, Brunner P, Mayer M, Surkhi OI, Riu PJ, Scharfetter H. Indicator for hydration balance during haemodialysis based on anisotropic FEM. Physiol Meas 2008; 29:S479-89. [DOI: 10.1088/0967-3334/29/6/s40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
45
|
LEE SEOUNGWOO, PARK GEUNHO, LEE SEUNGWON, UM WOOKHYUN, KWON SUHYUN, SONG JOONHO, KIM MOONJAE. Different pattern of fluid loss from the lower extremities in normohydrated and overhydrated stage 5 chronic-kidney-disease patients after haemodialysis. Nephrology (Carlton) 2008; 13:109-15. [DOI: 10.1111/j.1440-1797.2007.00832.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
46
|
Nagai M, Komiya H, Mori Y, Ohta T, Kasahara Y, Ikeda Y. Development of a New Method for Estimating Visceral Fat Area with Multi-Frequency Bioelectrical Impedance. TOHOKU J EXP MED 2008; 214:105-12. [PMID: 18285667 DOI: 10.1620/tjem.214.105] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Masato Nagai
- Department of Exercise Physiology, Utsunomiya University
| | - Hideaki Komiya
- Department of Exercise Physiology, Utsunomiya University
- Department of Public Health, Dokkyo University, School of Medicine
| | - Yutaka Mori
- Department of Internal Medicine, National Hospital Organization Utsunomiya National Hospital
| | - Teruo Ohta
- Department of Internal Medicine, Sirasawa Hospital
| | | | | |
Collapse
|
47
|
Turner AA, Lozano-Nieto A, Bouffard M. Generalizability of extracellular-to-intracellular fluid ratio using bio-impedance spectroscopy. Physiol Meas 2006; 27:385-97. [PMID: 16537980 DOI: 10.1088/0967-3334/27/4/005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Generalizability theory was used to investigate the score consistency of observed extracellular fluid/intracellular fluid (ECF/ICF) ratio measurements for both the global and leg-segmental bio-impedance spectroscopy methods. The test instrument used was a Xitron Hydra ECF/ICF Bio-Impedance Analyzer System, model 4200 (Xitron Technologies, San Diego, CA). Fifty able-bodied American men (17 to 72 years) and 50 able-bodied American women (17 to 76 years) volunteered as experimental subjects. Xitron continuous global and leg-segmental ECF/ICF procedures for testing were followed for assessing subjects in both the standing erect and lying supine postures. A two-facet, person-by-trial, completely crossed design was used, and all facets were treated as random. Data were independently analyzed for each method, each body posture and each sex group. The major findings of this study were: (1) the leg-segmental method was superior in producing the higher G-coefficients when compared to the global method regardless of gender or posture; (2) the global method resulted in higher G-coefficients in males compared to females regardless of posture; (3) when the global method was used, the relative and absolute error variances were higher for females while the opposite trend was observed when the segmental method was used and (4) when using the global method, the precision of the ECF/ICF ratio scores in females could be increased by simply using the mean of several trials (e.g., by using the mean of 5, 10 or more test trials).
Collapse
Affiliation(s)
- A Allan Turner
- College of Education, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | | | | |
Collapse
|
48
|
Piccoli A, Pastori G, Guizzo M, Rebeschini M, Naso A, Cascone C. Equivalence of information from single versus multiple frequency bioimpedance vector analysis in hemodialysis. Kidney Int 2005; 67:301-13. [PMID: 15610256 DOI: 10.1111/j.1523-1755.2005.00083.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In suspended cells, low-frequency current only passes through extracellular fluids, while current at higher frequencies passes through extra- and intracellular fluids. Cells in soft tissues are in contact with each other, which causes tissue anisotropy, meaning that impedance changes along different cell directions, with part of low-frequency current also passing through cells. Hence, equivalent information on body impedance change is expected at all frequencies, which we proved in a dynamic condition of fluid removal with hemodialysis. METHODS We performed whole-body impedance spectroscopy (496 frequencies from 4 to 1024 kHz, SEAC SFB3 analyzer; Brisbane, Australia) before and during fluid removal (0, 60, 120, 180 min, 2.5 kg) in 67 hemodialysis patients. With increasing current frequency, resistance (R) decreases and reactance (Xc) moves along the Cole's semicircle on the R-Xc plane. RESULTS The Cole's semicircles progressively enlarged and moved to the right on the R-Xc plane following fluid removal (increase in both R and Xc values at any given frequency). Xc values at 5 kHz (expected values close to 0 Ohm) were 70% of the maximun Xc, indicating an intracellular current flows at low frequencies. The correlation coefficient between R at 50 kHz (standard frequency) and R at other frequencies ranged from 0.96 to 0.99, and the correlation coefficient between Xc at 50 kHz and Xc at other frequencies at any time point ranged from 0.65 to 0.99. CONCLUSION From high Xc values at low frequency, tissue anisotropy is inferred. Intra- and extracellular current flow causes equivalence of information based on functions of R and Xc measurements made at 50 kHz versus other frequencies.
Collapse
Affiliation(s)
- Antonio Piccoli
- Department Scienze Mediche e Chirurgiche, University of Padova, Padova, Italy.
| | | | | | | | | | | |
Collapse
|
49
|
Carter M, Morris AT, Zhu F, Zaluska W, Levin NW. Effect of body mass index (BMI) on estimation of extracellular volume (ECV) in hemodialysis (HD) patients using segmental and whole body bioimpedance analysis. Physiol Meas 2005; 26:S93-9. [PMID: 15798250 DOI: 10.1088/0967-3334/26/2/009] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of the study was to investigate whether body mass index (BMI) influences the estimation of extracellular volume (ECV) in hemodialysis (HD) patients when using segmental bioimpedance analysis (SBIA) compared to wrist-to-ankle bioimpedance analysis (WBIA) during HD with ultrafiltration (UF). Twenty five HD patients (M:F 19:6,) were studied, and further subdivided into two groups of patients, one group with a high BMI (25 kg m-2) and the other with a low BMI (<25 kg m-2). Segmental (arm, trunk, leg) and wrist-to-ankle bioimpedance measurements on each patient were performed using a modified Xitron 4000B system (Xitron Technologies, San Diego, CA). No differences in extracellular resistance (R(E), ohms) between wrist-to-ankle (R(W)) and sum of segments (R(S)) were noted for either the high BMI (489.2+/-82 ohm versus 491.6+/-82 ohm, p=ns) or low BMI groups (560.8+/-77 ohm versus 557.5+/-75 ohm, p=ns). UF volume (UFV, liters) did not differ significantly between the groups (4.0+/-0.9 L versus 3.3+/-1.0 L, p=ns), but change in ECV (DeltaECV) differed not only between methods: WBIA versus SBIA in the high BMI group (2.74+/-1.1 L versus 3.64+/-1.4 L, p<0.001) and in the low BMI group (1.86+/-0.9 L versus 2.91+/-1.0 L, p<0.05) but also between the high and lower BMI groups with WBIA (2.74+/-1.1 L versus 1.86+/-0.9 L, p<0.01). However, there was no significant difference in SBIA between BMI groups. This study suggests that the segmental bioimpedance approach may more accurately reflect changes in ECV during HD with UF than whole body impedance measurements.
Collapse
Affiliation(s)
- Mary Carter
- Renal Research Institute and Beth Israel Medical Center, New York, NY 10128, USA
| | | | | | | | | |
Collapse
|
50
|
Di Iorio BR, Scalfi L, Terracciano V, Bellizzi V. A systematic evaluation of bioelectrical impedance measurement after hemodialysis session. Kidney Int 2004; 65:2435-40. [PMID: 15149357 DOI: 10.1111/j.1523-1755.2004.00660.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND There is still no definitive indication about the ideal point of time to perform bioimpedance analysis (BIA) in hemodialysis patients. Furthermore, the interpretation of data in this regard is difficult because there is still no comprehensive information about the fluctuations in BIA variables occurring in these subjects. The aim of this study was to assess BIA changes occurring in hemodialysis and specifically in the dry-weight state. METHODS We studied 27 anuric patients (20 males and 7 females; age 56.1 +/- 13.7 years) on chronic hemodialysis. Single-frequency BIA (R, resistance; Xc, reactance; and PhA, phase angle) was performed (1) before and at the end of hemodialysis (dialysis period); (2) 15, 30, 60, 90, and 120 minutes after hemodialysis (postdialysis period); and (3) 24, 48, and 68 hours after hemodialysis (interdialysis period). RESULTS Body weight decreased by 2.8 +/- 0.8 kg during hemodialysis, was unchanged during the postdialysis period, and progressively rose during the interdialysis period. At the same time, BIA variables significantly increased during hemodialysis (R, 453 +/- 74 and 542 +/- 98 ohm; Xc, 38 +/- 10 and 53 +/- 16 ohm; P < 0.05), remained stable over the 120-minute period after treatment (R, 538 +/- 94, 539 +/- 95, 538 +/- 94, 541 +/- 95, and 544 +/- 95 ohm; and Xc, 53 +/- 15, 53 +/- 15, 51 +/- 16, 52 +/- 16, and 52 +/- 16 ohm; NS), and subsequently declined [R, 471 +/- 79 (P= <0.05 vs. postdialysis), 449 +/- 71 (P= <0.05 vs. postdialysis), 424 +/- 68 (P= <0.05 vs. postdialysis) ohm; Xc, 42 +/- 13 (P= <0.05 vs. postdialysis), 37 +/- 10 (P= <0.05 vs. postdialysis), 34 +/- 13 (P= <0.05 vs. postdialysis) ohm]. The stability of BIA measures during postdialysis was confirmed by the constant relationship found between R/height and Xc/height. Also PhA increased after dialysis (4.8 +/- 1.1 degrees vs. 5.7 +/- 1.3 degrees, P < 0.05), was unchanged during the following 120 minutes and decreased in the interdialysis period (5.1 +/- 1.3 degrees, 4.8 +/- 1.0 degrees, and 4.5 +/- 1.1 degrees, P < 0.05). At the end of hemodialysis and during the postdialysis period total body water (TBW) estimated from BIA was similar on average to TBW calculated using Watson formulas (37.2 +/- 6.3 L vs. 36.2 +/- 5.7 L, NS). On the contrary, when patients were hyperhydrated BIA significantly overestimated the Watson's values. CONCLUSION In hemodialysis patients BIA variables fluctuate to a considerable extent (with the highest values immediately after hemodialysis), but remain constant and highly reproducible over the 120 minutes after the end of hemodialysis, that is, in a dry-weight state. Thus, taking into consideration that the point in time chosen for performing BIA is crucial to properly assess body composition, BIA can be appropriately performed at anytime during the postdialysis period, provided that hydration status does not change due to food or drink consumption.
Collapse
|