Prognostic Value of Bioelectrical Impedance Analysis for Assessment of Fluid Overload in ICU Patients: A pilot Study

Overview

Journal Anaesthesiol Intensive Ther

Specialties Anesthesiology
Critical Care

Date 2021 Feb 24

PMID 33625819

Citations 9

Authors

Robbert Cleymaet

Thomas Jonathan Scheinok

Hanne Maes

Amber Stas

Luca Malbrain

Inneke De Laet

Karen Schoonheydt

Hilde Dits

Niels van Regenmortel

Michael Mekeirele

Andrea Minini

Paolo Severgnini

Adrian Wong

Manu L N G Malbrain

Affiliations

Soon will be listed here.

Abstract

Introduction: The non-invasive analysis of body fluid composition with bio-electrical impedance analysis (BIA) provides additional information allowing for more persona-lised therapy to improve outcomes. The aim of this study is to assess the prognostic value of fluid overload (FO) in the first week of intensive care unit (ICU) stay.

Material And Methods: A retrospective, observational analysis of 101 ICU patients. Whole-body BIA measurements were performed, and FO was defined as a 5% increase in volume excess from baseline body weight.

Results: Baseline demographic data, including severity scores, were similar in both the fluid overload-positive (FO+, n = 49) patients and in patients without fluid overload (FO-, n = 52). Patients with FO+ had significantly higher cumulative fluid balance during their ICU stay compared to those without FO (8.8 ± 7.0 vs. 5.5 ± 5.4 litres; P = 0.009), VE (9.9 ± 6.5 vs. 1.5 ± 1.5 litres; P < 0.001), total body water (63.0 ± 9.5 vs. 52.8 ± 8.1%; P < 0.001), and extracellular water (27.0 ± 7.3 vs. 19.6 ± 3.7 litres; P < 0.001). The presence of 5%, 7.5%, and 10% fluid overload was directly associated with increased ICU mortality rates. The percentage fluid overload (P = 0.039) was an independent predictor for hospital mortality.

Conclusions: A higher mortality rate in ICU-patients with FO was observed. FO is an independent prognostic factor because neither APACHE-II, SOFA, nor SAPS-II significantly differed on admission between survivors and non-survivors. Further research is needed to confirm these data prospectively and to evaluate whether BIA-guided deresuscitation in the subacute phase will improve mortality rates.

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