Body hydration assessment using bioelectrical impedance vector analysis in neurologically impaired children

Calcaterra, Valeria; Cena, Hellas; Manuelli, M.; Sacchi, Lucia; Girgenti, Vincenza; Larizza, Cristiana; Pelizzo, Gloria

doi:10.1038/s41430-018-0384-7

Cited by 9 publications

(12 citation statements)

References 6 publications

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“…The high prevalence of OD in our study led up to 96.4% of our students to consume below the daily basal recommendations of fluids, causing dehydration in the intracellular compartment water in 70% (14). Other studies have also reported that people with NI are at a higher risk for dehydration [ 130 , 131 ]. Deficiency of body water due to OD and low intake causes dehydration, which might also contribute to impaired cognitive function [ 132 , 133 ].…”

Section: Discussionmentioning

confidence: 99%

“…The swallowing disorders of these individuals caused low water intake, which was also associated with the difficulties encountered by caregivers to ensure safe intake. Studies also found a relationship between the state of hydropenia and oral-motor impairment of individuals [ 134 ], as well as greater dehydration in subjects with ND compared to a typical development child [ 130 , 131 ].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

et al. 2021

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Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L’Arboç, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II–III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

et al. 2021

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“…Despite BMI is not a reliable indicator of nutritional status and it may not have an etiological role in pubertal disorders (4), in this pediatric population severe undernutrition is associated with body composition disturbances (15). Undernutrition and low body fat mass, or an altered ratio of lean mass to body fat, seem to play a crucial role in the initiation of puberty (16).…”

Section: Discussionmentioning

confidence: 99%

Disorders of Puberty in Severely Neurologically Impaired Children: Is Delayed Puberty an Underestimated Problem?

et al. 2019

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Introduction: In children with disabilities, precocious puberty (PP) has been reported, however there is a paucity of studies on delayed puberty (DP) in neurologically impaired (NI) children.Patients and Methods: We retrospectively evaluated 65 patients with severe disabilities (6–18 years). DP was considered whenever the following criteria where satisfied, respectively, for girls and boys, absence of breast development by age 13 or menarche by age 15, absence of at least 4 mL testicular growth volume or 2.5 cm length by age 14. PP was defined as the presence of puberty signs at <8 and 9 years of age, respectively, for girls and boys. In all patients, a physical examination was performed and a family history of DP was obtained. A hormonal panel was evaluated when puberty disorders were detected. As a control group we evaluated 50 age-matched healthy subjects.Results: Puberty disorders were observed in 12 NI patients and in one control (18.5 vs. 2%, p < 0.01). DP was detected in 8 NI subjects (3M/5F) and in one healthy boy (p = 0.04), without differences between genders among patients from the NI group (p = 0.2), and compared with the controls (p = 0.4). In five of the eight NI subjects, Tanner stage 1 was observed; in three subjects adrenarche was present without pubertal progression for more than 2 years. Low levels of gonadotropins were detected in all NI subjects with DP. The number of subjects with a BMI <-3SDS was higher in NI patients with DP compared to NI subjects with normal puberty (p < 0.01); normal weight was detected in one healthy boy. The family history for pubertal delay was negative in all NI patients with DP and positive in the control subject.Conclusion: NI children and adolescents may experience delayed pubertal changes. An endocrinological follow-up with pubertal development monitoring is strongly recommended in order to evaluate whether targeted interventions may improve outcomes.

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“…Disease management usually includes nutritional assessment, in view of the potentially detrimental effects of both overweight (increasing respiratory/skeletal muscle work) and undernutrition (reflecting worsening of pulmonary function and predisposing to respiratory infections). Body Impedance Vectorial Analysis (BIVA) is a tool for noninvasive, indirect assessment of fat-free-mass (FFM), fat mass (FM), body cell mass (BCM), and Phase Angle (PhA) (Calcaterra et al, 2019). PhA is an index of nutritional status; it is used as a prognostic index of survival in several diseases (Calcaterra et al, 2019;Garlini et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Bioimpedance Phase Angle as a Prognostic Tool in Late-Onset Pompe Disease: A Single-Centre Prospective Study With a 15-year Follow-Up

Ravaglia¹,

Giuseppe

Carlucci

et al. 2022

Front. Cell Dev. Biol.

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Background: Late-onset Pompe disease (LOPD) is an autosomal-recessive metabolic myopathy caused by deficiency of the lysosomal enzyme Acid Alpha—Glucosidase (GAA), leading to glycogen accumulation in proximal and axial muscles, and in the diaphragm. Enzyme Replacement Therapy (ERT) with recombinant GAA became available in 2006. Since then, several outcome measures have been investigated for the adequate follow-up of disease progression and treatment response, usually focusing on respiratory and motor function. Prognostic factors predicting outcome have not been identified till now.Methods: In this single Centre, prospective study, we evaluate the response to enzyme replacement therapy in 15 patients (7 males) with LOPD in different stages of disease, aged 49.4 ± 16.1, followed-up for 15 years. Treatment response was measured by the 6-min walking test, vital capacity in supine and upright position, respiratory muscle strength, muscle MRI, manual muscle testing. We investigated the usefulness of Body Impedance Vectorial Analysis for serial body composition assessment.Results: Although most patients with LOPD benefit from long-term treatment, some secondary decline may occur after the first 3–5 years. Some nutritional (lower body mass index, higher fat free mass, higher phase angle) and disease parameters (higher creatinine and shorter disease duration at the beginning of treatment) seem to predict a better motor outcome. Lower Phase Angle, possibly reflecting loss of integrity of skeletal muscle membranes and thus treatment mis-targeting, seems to correlate with worse treatment response on long-term follow-up.Conclusion: Body Impedance Vectorial Analysis is a fast, easily performed and cheap tool that may be able to predict long-term treatment response in patients with LOPD. Low Phase angle may serve as a marker of muscle quality and may be used to predict the response to a muscle-targeted intervention such as ERT, thus improving the identification of patients needing a closer follow-up due to higher fragility and risk of deterioration.

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Body hydration assessment using bioelectrical impedance vector analysis in neurologically impaired children

Cited by 9 publications

References 6 publications

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

Disorders of Puberty in Severely Neurologically Impaired Children: Is Delayed Puberty an Underestimated Problem?

Bioimpedance Phase Angle as a Prognostic Tool in Late-Onset Pompe Disease: A Single-Centre Prospective Study With a 15-year Follow-Up

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