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Original Articles
- Validity of Bioelectrical Impedance Analysis for Older Amputees with Leprosy
- Jihyun Lee, Seorin Doo, Yeonhee Lee, Jaeyoung Ahn, Yookyoung Park, Hyun Joo Shin, Jae-myeong Lee
- Surg Metab Nutr 2021;12(1):7-15. Published online June 30, 2021
- DOI: https://doi.org/10.18858/smn.2021.12.1.7
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Abstract
PDF - Purpose: Bioelectrical impedance analysis (BIA) evaluates body composition and electrical resistance according to weight and height but assumes all limbs are intact. This study evaluated the validity and accuracy of BIA in older amputees with leprosy.
Materials and Methods: We evaluated BIA’s effectiveness for determining body composition by measuring muscle mass, water percentage, and physical resistance, including phase angle, in older amputees with leprosy. BIA was performed on 42 individuals with leprosy aged ≥65 years. Comparative analyses were performed by amputation types (left lower limbs, right lower limbs, bilateral lower limbs, and non-amputees). Twenty people without leprosy or amputations of similar age, height, and weight were considered controls.
Results: Between the controls, amputee, and the controls without leprosy, BIA showed significant mean differences in skeletal muscle mass (22.5±5.6 kg, 19.6±5.6 kg, 18.2±3.9 kg, respectively; P=0.037); whole-body extracellular water (ECW) ratios (0.410±0.011, 0.401±0.007, 0.393±0.009, respectively; P<0.001) and phase angle (4.2±1.2, 4.4±0.7, 5.0±0.8, respectively; P=0.029). The bilateral lower limb amputation group (median, 0.415; range, 0.407–0.426) showed significantly higher whole-body ECW values than the non-amputee group (median, 0.401, range: 0.391–0.415) (P=0.013). Right leg lean mass was highest in the right lower limb amputation group, followed by bilateral lower limb amputation, non-amputee, and left lower limb amputation groups (median: 9.86, 6.04, 5.02, 3.95, respectively, P=0.001). As the length of the amputated lower limb was shortened, the lower limb's impedance decreased. However, BIA was evaluated without reflecting the shortened length, resulting in an error in the skeletal muscle mass readings.
Conclusion: Phase angle, ECW ratio, and bioelectrical impedance vector analysis obtained by BIA appeared accurate, but the skeletal muscle mass showed significant errors for amputated areas.
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- Usefulness of Bioelectrical Impedance Analysis as a Guidance of Fluid Management in Critically Ill Patients after Major Abdomen Surgery; a Single Center, Prospective Cohort Study
- Yoon Ji Chung, Eun Young Kim
- Surg Metab Nutr 2020;11(2):53-60. Published online December 30, 2020
- DOI: https://doi.org/10.18858/smn.2020.11.2.53
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Abstract
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- Purpose: We evaluated the patterns and changes in bioelectrical impedance analysis parameters of patient who underwent abdominal surgery throughout the early period in surgical intensive care unit stay.
Materials and Methods: From May 2019 to April 2020, patients admitted to surgical intensive care unit for more than 48 hours after surgery were enrolled. Body composition and volume status of patients were measured prospectively using portable bioelectrical impedance analysis device every morning for three days from the day of intensive care unit admission. Overhydration was defined as the case where the value of extracellular water ratio is above 0.390, and the participants were daily classified into overhydration or normohydration group. Relationship between daily volume status measured by bioelectrical impedance analysis and outcomes was assessed.
Results: 107 patients who underwent abdominal surgery and 26 patients who underwent endovascular surgery were reviewed as control group. During the first postoperative 48 hours, most of them showed overhydration status, while the rate of overhydaration was significantly lower in the control group. Overhydration status on day 3 was significant predictors of postoperative morbidities (OR 5.709, 95% CI 2.199~14.819, P<0.001) and in-hospital mortality (OR 4.244, 95% CI 1.398~12.883, P<0.001).
Conclusion: Overhydration status by extracellular water ratio on postoperative day 3 needs careful monitoring and appropriate interventions to improve the postoperative morbidities and in-hospital mortality. Bioelectrical impedance analysis could be a simple, easy and useful tool to monitor the volume status of patients who requiring intensive fluid resuscitation after abdominal surgery.
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- Sequential Changes in Body Composition Using Bioelectrical Analysis during the Metabolic Response in Critically Ill Surgical Patients
- Seok Rae Park, Seung Hwan Lee, Kyung Sik Kim, Hosun Lee, Tae Hwa Hong, Jae Gil Lee
- Surg Metab Nutr 2017;8(1):13-16. Published online June 30, 2017
- DOI: https://doi.org/10.18858/smn.2017.8.1.13
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Abstract
PDF
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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