Bioelectrical impedance spectrum analysis(BISA) in critically ill patients.
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概要
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Bioelectrical impedance analysis (BIA) is widely used for assessing body composition especially fat free mass (FFM) or total body water (TBW). Bioelectrical impedance (BI) has frequency dependency, because of the capacitance caused by the cell membrane which separates TBW into extracellular fluid (ECF) and intracellular fluid (ICF). Thus, analysis of the frequency spectrum of BI (BISA) may provide further information about fluid distribution. Cole and Cole established the equivalent circuit model of the BIS to estimate the specific resistances of ECF and ICF. As critically ill patients are known to have fluid retention and disturbed fluid distribution, we evaluated whether BISA is applicable to this group of patients. This study was designed to determine 1) whether Cole's equation could be applied to the BI spectrum (BIS) obtained from this group of patients, and 2) whether the estimated conductance of ECF or ICF (Ge, Gi) has a significant relation with the pathophysiological changes in these patients. Fifty-six measurements of BIS were obtained from seven ICU patients, whose APACHE II scores were more than 20. The correlation coeffcient (r) of the measured impedance (Z) and estimated Z from Cole's equation was 0.999 in overall measurements. The resistance index of ECF (RIe) showed a high correlation with fluid balance (r=0.915), though the slope of the regression line was different for each individual. This observation suggested a limitation in estimating the absolute value of the fluid change from this regression. However, the changes in Ge and Gi correlated not only with fluid balance but also with the pathophysiological changes, such as WBC, CRP or TP, on an individual basis. In conclusion, Cole's equation could be applied to BIS in critically ill patients. BISA could be a novel, non-invasive and useful technique for assessing fluid distribution in critically ill patients. However, further study is needed to evaluate the significant relation between BISA and pathophysiology in these patients.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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