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Sequential Changes in Body Composition Using Bioelectrical Analysis during the Metabolic Response in Critically Ill Surgical Patients
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Seok Rae Park, Seung Hwan Lee, Kyung Sik Kim, Hosun Lee, Tae Hwa Hong, Jae Gil Lee
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Surg Metab Nutr 2017;8(1):13-16. Published online June 30, 2017
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DOI: https://doi.org/10.18858/smn.2017.8.1.13
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 Abstract
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Purpose: Assessment of sequential changes in body composition during the metabolic response in critically ill surgical patients is essential for optimal nutritional support and management. Bioelectrical impedance analysis (BIA) is an easy, portable, and quick way to assess body composition. Thus, the aim of this study was to evaluate the sequential changes in body composition and the validity of Direct segmental Multi-frequency BIA in critically ill surgical patients. Materials and Methods: Twenty-three patients admitted to the intensive care unit (ICU) after major surgery were measured for body composition by multiple-frequency BIA after intensive care unit admission as well as 3 and 7 days later. Repeated-measures analysis of variance (ANOVA) was used to detect significant changes over time. Results: The average length of intensive care unit stay was 4.3 days. Total body water, extracellular water, skeletal muscle mass (SMM), soft lean mass, and fat-free mass (FFM) increased during the first 72 h of intensive care unit admission, after which they decreased slightly. On the other hand, fat mass decreased during the first 72 h of intensive care and then increased. However, arm circumference (AC), arm muscle circumference (AMC), and waist circumference (WC) gradually decreased by day 7 (P<0.001). Conclusion: In this study, AC, AMC, WC, and direct segmental Multi-frequency BIA were less affected by initial resuscitation in the intensive care unit (ICU). Therefore, segmental BIA may be useful for critical ill patients in altered hydration states.
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