Early Detection of Muscle Weakness and Functional Limitations in the Critically Ill: A Retrospective Evaluation of Bioimpedance Spectroscopy

Baldwin, Claire; Fetterplace, Kate; Beach, Lisa; Kayambu, Geetha; Paratz, Jennifer; Earthman, Carrie P.; Parry, Selina M.

doi:10.1002/jpen.1719

Cited by 11 publications

(12 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A prospective study among 60 ventilated ICU patients found that a cumulative energy-deficit during ICU stay was independently associated with loss of BIS-FFM between inclusion and ICU discharge, as well as with ICU-acquired weakness [ 40 ▪▪ ]. In a retrospective post hoc analysis, including this study, these associations disappeared [ 41 ▪ ]. However, raw parameters remained related to muscle weakness [ 41 ▪ ] ∗ .…”

Section: Nutrition Managementmentioning

confidence: 95%

See 1 more Smart Citation

Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness

Moonen

Zanten

2021

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of review Insight into body composition is of great value in the ICU. Bioelectric impedance analysis (BIA) is the most applicable bedside technique. However, bioimpedance has not been validated in the critically ill, and the interpretation of the measurements poses challenges. This review discusses the potential clinical applications of BIA and explores caveats and solutions to its use in the intensive care setting. Recent findings A correlation is repeatedly found between raw impedance parameters, fluid ratios, overhydration, and adverse outcome of critical illness. However, cut-off and reference values remain elusive. Experience with BIA-guided fluid management in the ICU is limited. BIA-derived muscle mass appears a promising biomarker for sarcopenia, correlating well with CT-analysis. Body cell mass and fat-free mass provide potential use in estimation of metabolic rate, protein requirements and pharmacokinetics. Several methods of reducing bias in BIA parameters in critical illness require validation. Summary There are currently too many uncertainties and discrepancies regarding interpretation of bioimpedance in critical illness, to justify therapeutic consequences. However, there are several promising areas of research, concerning some of the most urgent clinical problems in intensive care, emphasizing the need to evaluate further the use and interpretation of bioimpedance in the intensive care setting.

show abstract

Section: Nutrition Managementmentioning

confidence: 95%

“…In a retrospective post hoc analysis, including this study, these associations disappeared [ 41 ▪ ]. However, raw parameters remained related to muscle weakness [ 41 ▪ ] ∗ .…”

Section: Nutrition Managementmentioning

confidence: 95%

Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness

Moonen

Zanten

2021

Current Opinion in Critical Care

View full text Add to dashboard Cite

show abstract

“…However, it has a relevant prognostic value, and it has been demonstrated that low skeletal muscle quality at ICU admission (as assessed by CT-derived skeletal muscle density) is independently associated with higher 6-month mortality in mechanically ventilated patients, thus reinforcing the importance of muscle quality and quantity as prognostic factors in the ICU [ 26 ]. Serial BIS [ 27 ] may be less accessible at the bedside than US but also requires less training for its use. However, it may be misleading, as its measurements are mainly linked to inaccuracies due to large fluxes in fluid status in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Novel High-Quality Sonographic Methods to Diagnose Muscle Wasting in Long-Stay Critically Ill Patients: Shear Wave Elastography, Superb Microvascular Imaging and Contrast-Enhanced Ultrasound

et al. 2021

View full text Add to dashboard Cite

Novel ultrasound (US) methods are required to assess qualitative changes in the quadriceps rectus femoris (QRF) muscle when evaluating mechanically ventilated, long-stay ICU patients with suspected neuromuscular acquired weakness (ICUAW). Our aim was to analyze novel US muscle assessment methods in these patients versus healthy controls by carrying out a prospective observational study. Shear wave elastography (SWE) showed, with a receiver operating characteristic (ROC) curve of 0.972 (95% confidence interval (CI) = 0.916–1.000), that patients increased muscle stiffness associated with muscle fibrosis when diagnosed with ICUAW. We also performed, for the first time, superb microvascular imaging (SMI), which is an innovative US technique designed for imaging microvascularization unseen with color Doppler US, and observed that 53.8% of cases had significantly lower QRF muscle microvascular angiogenic activity than controls (p < 0.001). Finally, we used contrast-enhanced ultrasound (CEUS) to analyze maximum and minimum QRF muscle perfusion and obtained a ROC curve of 0.8, but when used as markers for SMI, their diagnostic capacity increased to 0.988 (CI = 0.965–1) and 0.932 (CI = 0.858–1), respectively. These findings show, for the first time, that these novel sonographic muscle methods should be used for their diagnostic capacity when assessing sarcopenic processes associated with this group of critically ill patients.

show abstract

“…On the other hand, the phase angle (phase difference between current and voltage) measured by the BIA method represents cell membrane status and is useful for the qualitative assessment of the skeletal muscle in critically ill patients. Phase angle correlates with the decreased CT value of the skeletal muscle (r = 0.70-0.77) 39,44) and the decreased Medical Research Council score (rs = 0.70) 46) .…”

Section: Biamentioning

confidence: 98%

Skeletal muscle mass assessment in critically ill patients: method and application

Tanaka

Katayama

Okura

et al. 2022

Ann. Cancer Res. Therap.

View full text Add to dashboard Cite

The skeletal muscle has a significant role on physical functions, and the assessment of the skeletal muscle is important in critically ill patients. Computed tomography (CT), ultrasound examination, bioelectrical impedance analysis (BIA) device, and biomarkers can all be used to assess skeletal muscle mass. CT is useful for accurately measuring skeletal muscle mass, and the measurement is conducted at the third lumbar vertebra level as the gold standard. However, the assessment using CT is done retrospectively because CT involves radiation exposure and requires patients to be transported to the examination room. On the other hand, ultrasound and BIA are noninvasive and can be used at the bedside to assess longitudinal skeletal muscle mass. However, accurate assessment requires knowledge and skills. Assessments using BIA should be carefully interpreted because critically ill patients are under dynamic fluid change and edema. Furthermore, various biomarkers for the assessment of skeletal muscle mass have been recently reported. Appropriate skeletal muscle assessment will contribute to the nutrition and rehabilitation intervention of critically ill patients so that they can return to society.

show abstract

Early Detection of Muscle Weakness and Functional Limitations in the Critically Ill: A Retrospective Evaluation of Bioimpedance Spectroscopy

Abstract: Medical Centre Foundation 'seeding grant'. Maintains a clinical physiotherapy position at the recruitment site, Flinders Medical Centre.

Cited by 11 publications

References 49 publications

Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness

Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness

Novel High-Quality Sonographic Methods to Diagnose Muscle Wasting in Long-Stay Critically Ill Patients: Shear Wave Elastography, Superb Microvascular Imaging and Contrast-Enhanced Ultrasound

Skeletal muscle mass assessment in critically ill patients: method and application

Contact Info

Product

Resources

About