Abstract
Bioelectrical impedance analysis (BIA) is a promising tool to evaluate the body composition of critically-ill patients. The present study aimed to assess its value as a fluid management monitoring tool during standardized deresuscitation strategy. A historical cohort of critically-ill adult patients with fluid overload and continuous renal replacement therapy was used to explore both relationship and agreement between changes in cumulative fluid balance and BIA-derived hydration variables within the 5 days following initiation of deresuscitation strategy using net ultrafiltration. Correlations were described using Spearman’s rank correlation coefficient, and agreement using Bland–Altman analysis for repeated measurements. Sixty-one couples of fluid shift measurements from 30 patients were analyzed. The deresuscitation strategy induced a negative mean (± SD) cumulative fluid balance (− 4.2 ± 3.8 L) and a significant decrease in extra- and intracellular water (P < 0.001). Decreases in extra- and intracellular water were independent of weight variations inputted in the BIA device. Total body water (rho = 0.63), extracellular water (rho = 0.68), and intracellular water (rho = 0.67) were significantly correlated with cumulative fluid balance (all P values < 0.001). The limits of agreement did not allow interchangeability for a delta of 2L between cumulative fluid balance and BIA-derived hydration variables (P > 0.05). BIA hydration-derived variables are significantly correlated with cumulative fluid balance but the large limits of agreements exclude interchangeability of the measures.
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All de-identified datasets are available for secondary analysis upon reasonable request to the corresponding author.
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Inbody® (Seoul, South Korea) kindly provided the Inbody S10 machine for bioelectrical analysis but did not participate in the study or the drafting of the manuscript. This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Study concept and design: MR, MJL, JLF. Acquisition of data: CC, MR. Interpretation of data: MR, MJL, JLF. Drafting of manuscript: MR, MJL. Statistical analysis: MR. Study supervision: MR, MJL. Critical revision of the manuscript for important intellectual content: MR, MJL, CC, JLF. Final approval of the version to be published: MR, MJL, CC, JLF. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: MR, MJL, CC, JLF.
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The study protocol was approved by the International Review Board (Hospices Civils de Lyon, IRB: 00013204).
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Ruste, M., Chabanol, C., Fellahi, JL. et al. Bioelectrical impedance analysis during deresuscitation: correlation and agreement with cumulative fluid balance in ICU patients. J Clin Monit Comput 37, 679–687 (2023). https://doi.org/10.1007/s10877-022-00923-0
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DOI: https://doi.org/10.1007/s10877-022-00923-0