Annals of Clinical Nutrition and Metabolism

Original Article

Clinical Application of Bioelectrical Impedance Analysis and its Phase Angle for Nutritional Assessment of Critically III Patients: Hyung-Sook Kim, Eun Sook Lee, Yeon Joo Lee, Jae Ho Lee, Choon-Taek Lee, Young-Jae Cho; J Clin Nutr 2015;7(2):54-61. Published online August 31, 2015; DOI: https://doi.org/10.15747/jcn.2015.7.2.54

Purpose:

Phase angle (PA) is objectively determined from resistance and reactance measured by bioelectrical impedance analysis (BIA)−a quick, noninvasive method. The aim of this study was to evaluate the clinical application of PA by BIA for nutritional assessment of critically ill patients.

Methods:

Eighty nine adult patients admitted to a medical intensive care unit (ICU) of a tertiary academic hospital from August 2012 to September 2013 were analyzed. PA values were measured by direct segmental multi-frequency BIA. As traditional nutrition assessment tools, body mass index (BMI), serum albumin levels, total lymphocyte counts, and our hospital’s nutrition screening index (NSI) were also recorded. Correlations between the results of BIA and other traditional parameters were analyzed.

Results:

PA showed correlation with traditional nutritional parameters, including BMI (r=0.479), serum albumin (r=0.347), and NSI score (r=0.483). Patients with PA lower than the median value (3.5°) had significantly lower nutritional status, increased duration of mechanical ventilation (P=0.039), and increased length of ICU stay (P=0.041).

Conclusion:

PA, as a reflection of body cell mass, measured by BIA could be a potentially useful parameter for nutritional assessment in critically ill patients.

Citations

Citations to this article as recorded by

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Journal of Nutrition and Metabolism.2022; 2022: 1. CrossRef
Prognostic value of phase angle and bioelectrical impedance vector in critically ill patients: A systematic review and meta-analysis of observational studies
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Review Article

Use of Bioelectrical Impedance Analysis for Nutritional Treatment in Critically Ill Patients: Yeon Hee Lee, Jae Myeong Lee; J Clin Nutr 2015;7(1):9-14. Published online April 30, 2015; DOI: https://doi.org/10.15747/jcn.2015.7.1.9

Abstract PDF ePub

Patients in the intensive care unit (ICU) easily have large amounts of extracellular fluids, such as edema or ascites, because of cardiovascular instability under septic conditions and also have high risk of malnutrition while staying in the ICU. Traditional nutritional assessment parameters like body mass index have a limitation in ICU patients due to muscle atrophy and decrease of lean body mass. Bioimpedence analyses (BIA) can be used to assess body composition and are useful in performance of nutritional assessments in ICU patients. BIA can simply and noninvasively estimate body composition (total body water, extracellular water, intracellular water, body cell mass, and free fat mass etc.) by sending a weak electric current through the body. In particular, phase angle (PhA, phase difference between the voltage applied to the impedance and the current driven through it), one of the parameters of BIA, is related to cell membrane integrity or cell size. Low PhA can possibly imply malnutrition and PhA has been reported as a useful indicator of clinical outcomes or prognosis of severe patients. Additional study with clinical application of BIA in ICU patients is needed in order to confirm the usefulness of BIA.