Consensus paper on the use of BIVA (Bioeletrical Impendance Vector Analysis) in medicine for the management of body hydration

Somma, Salvatore Di; Lukaski, Henry C.; Codognotto, Marta; Peacock, W. Frank; Fiorini, Fulvio; Aspromonte, Nadia; Ronco, Claudio; Santarelli, Simona; Lalle, Irene; Autunno, A; Piccoli, Antônio

doi:10.4081/ecj.2011.4.6

Cited by 28 publications

(14 citation statements)

References 56 publications

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“…Several studies demonstrated that BIVA approach might be an useful tool to assess nutritional status in various conditions, including heart failure, sarcopenia, or Alzheimer disease [ 18 , 37 – 40 ]. Many available studies show negative correlations between bioelectrical parameters normalized to subjects’ height and BMI [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome – a 25 year cohort study

et al. 2016

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BackgroundThe purpose of this analysis was to investigate the relationship between body composition, metabolic parameters and endothelial function among physically active healthy middle-aged and older men.MethodsOut of 101 asymptomatic men prospectively tracked for traditional cardiovascular risk factors (mean observation period 25.1 years), 55 metabolically healthy individuals who maintained stable leisure time physical activity (LTPA) level throughout the observation and agreed to participate in the body composition assessment were recruited (mean age 60.3 ± 9.9 years). Body composition and raw bioelectrical parameters were measured with bioelectrical impedance analysis (BIA). Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system.ResultsStrong correlations were observed between lifetime physical activity (PA), aerobic fitness and most of analyzed body composition parameters. The strongest inverse correlation was found for fat mass (p < 0.01) while positive relationship for fat-free mass (p < 0.01), total body water (p < 0.05 for current aerobic capacity and p < 0.01 for historical PA), body cell mass (p < 0.001), muscle mass (p < 0.001), calcium and potassium (p < 0.01 and p < 0.001 for current aerobic capacity and p < 0.001 and p < 0.01 for historical PA, respectively) and glycogen mass (p < 0.001). Among metabolic parameters, HDL cholesterol (HDL-C) and uric acid were significantly associated with most body composition indicators. Regarding endothelial function, a negative correlation was found for RHI and body mass (p < 0.05) while positive relationship for RHI and body cell mass (p < 0.05), calcium (p < 0.05) and potassium mass (p < 0.05). Impaired endothelial function was observed among 8 subjects. Among bioelectrical parameters, impedance (Z) and resistance (R) normalized for subjects’ height were negatively related with body mass, body mass index (BMI) and waist circumference (p < 0.001); while reactance (Xc) normalized for patients’ height was negatively related with body mass (p < 0.05). The mean phase angle value was relatively high (8.83 ± 1.22) what reflects a good level of cellularity and cell function. Phase angle was positively related with body mass and BMI (p < 0.05).ConclusionsBoth fat mass and muscle mass components are important predictors of metabolic profile. Maintaining regular high PA level and metabolically healthy status through young and middle adulthood may have beneficial influence on body composition parameters and may prevent age-related decrease of fat-free mass and endothelial dysfunction.

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Section: Discussionmentioning

confidence: 99%

Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome – a 25 year cohort study

et al. 2016

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“…The microcirculation was quantified as: Perfused Vessel Density (PVD), Percentage of Perfused Vessels (PPV), and Microvascular Flow Index (MFI, 0 = no flow, 1 = intermittent flow, 2 = sluggish flow, 3 = continuous flow [ 33 , 34 ]. Bio-impedance analysis was measured to assess body composition, using the phase sensitive Akern ® BIA 101 Anniversary edition (GLNP Life Sciences) with the patient in horizontal position using four electrodes: two on hand and two on the foot and an alternating current of 400 μA with a frequency of 50 kHz [ 35 ]. BIA measures Resistance (R), reflecting total body water, Reactance (Xc) reflecting membrane capacitance (cellular mass and integrity), and calculates Phase Angle (PA), the arctangent of Xc/R x 180/π, a marker of general health.…”

Section: Methodsmentioning

confidence: 99%

Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study

et al. 2018

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BackgroundAcute kidney injury (AKI) complicates shock. Diagnosis is based on rising creatinine, a late phenomenon. Intrarenal vasoconstriction occurs earlier. Measuring flow resistance in the renal circulation, Renal Resistive Index (RRI), could become part of vital organ function assessment using Doppler ultrasound. Our aim was to determine whether RRI on ICU admission is an early predictor and discriminator of AKI developed within the first week.MethodsIn this prospective cohort of mixed ICU patients with and without shock, RRI was measured <24-h of admission. Besides routine variables, sublingual microcirculation and bioelectrical impedance were measured. AKI was defined by the Kidney Disease Improving Global Outcomes criteria. Uni- and multivariate regression and Receiver Operating Characteristics curve analyses were performed.ResultsNinety-nine patients were included, median age 67 years (IQR 59–75), APACHE III score 67 (IQR 53–89). Forty-nine patients (49%) developed AKI within the first week. AKI patients had a higher RRI on admission than those without: 0.71 (0.69–0.73) vs. 0.65 (0.63–0.68), p = 0.001. The difference was significant for AKI stage 2: RRI = 0.72 (0.65–0.80) and 3: RRI = 0.74 (0.67–0.81), but not for AKI stage 1: RRI = 0.67 (0.61–0.74). On univariate analysis, RRI significantly predicted AKI 2–3: OR 1.012 (1.006–1.019); Area Under the Curve (AUC) of RRI for AKI 2–3 was 0.72 (0.61–0.83), optimal cut-off 0.74, sensitivity 53% and specificity 87%. On multivariate analysis, RRI remained significant, independent of APACHE III and fluid balance; adjusted OR: 1.008 (1.000–1.016).ConclusionsHigh RRI on ICU admission was a significant predictor for development of AKI stage 2–3 during the first week. High RRI can be used as an early warning signal RRI, because of its high specificity. A combined score including RRI, APACHE III and fluid balance improved AKI prediction, suggesting that vasoconstriction or poor vascular compliance, severity of disease and positive fluid balance independently contribute to AKI development.Trial registrationClinicalTrials.gov NCT02558166.

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“…Recent evidence supports the use of BIVA in the assessment of volume overload in patients with acute heart failure 57 and discriminating pulmonary compared with cardiac dyspnoea, 58 as well as its importance in guiding individualised volume reduction therapy because of its high sensitivity and specificity. 59 Importantly, the combination of BIVA assessment of hydration status in conjunction with measurements of brain natriuretic peptide significantly decreased readmission rates of patients discharged with a diagnosis of heart failure. 58,60 REGIONAL FLUID ACCUMULATION Accumulation of fluid in the limbs may be a consequence of pathology or surgical intervention.…”

Section: Hydration Statusmentioning

confidence: 98%

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research

2013

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BACKGROUND/OBJECTIVES:Bioimpedance is the collective term that describes safe, non-invasive methods to measure the electrical responses to the introduction of a low-level, alternating current into a living organism, and the biophysical models to estimate body composition from bioelectrical measurements. Although bioimpedance techniques have been used for more than 100 years to monitor assorted biological components, the desire to translate bioelectrical measurements into physiological variables advanced the creation of empirical prediction models that produced inconsistent results. SUBJECTS/METHODS: This paper succinctly reviews the origin, and critically evaluates the conceptual models and the implementation of bioimpedance in clinical research, including indirect assessment of assorted physiological functions and body composition (fluid volumes and fat-free mass), classification of hydration, regional fluid accumulation, prognosis in disease and wound healing. RESULTS: Despite widespread and mounting interest in the use of bioimpedance to characterise body structure and function, most experimental findings reveal the limitations of existing physical models and reliance on multiple regression models for use in assessments of an individual. CONCLUSIONS: Contemporary applications of bioimpedance emphasise the value of bioimpedance variables per se in some novel biomedical applications with the objective of identifying opportunities for future outcome-based research.European Journal of Clinical Nutrition (2013) 67, S2-S9; doi:10.1038/ejcn.2012.149Keywords: resistance; reactance; impedance; phase angle; hydration; prognosis INTRODUCTIONThe history of the use of electrical current to explore tissues and reveal information about its composition and function recognises various contributions that are the basis for contemporary bioimpedance analysis.1 The chronology of bioimpedance research highlights an interesting sequence of events that range from the development of biophysical models to address applications in the estimation of pulsatile blood flow 2-4 to assessment of body composition.

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Consensus paper on the use of BIVA (Bioeletrical Impendance Vector Analysis) in medicine for the management of body hydration

Cited by 28 publications

References 56 publications

Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome – a 25 year cohort study

Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome – a 25 year cohort study

Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research

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