Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance.

Although the need to assess hydration is well recognized, laboratory tests and clinical impressions are impractical and lack sensitivity, respectively, to be clinically meaningful. Different approaches use bioelectrical impedance measurements to overcome some of these limitations and aid in the clas...

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Detalles Bibliográficos
Autores: Lukaski HC, Vega Diaz N, Talluri A, Nescolarde L
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p24422
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=24422
Access Level:acceso abierto
Palabra clave:bioelectrical impedance spectroscopy
bioelectrical impedance vector analysis
fluid overload
malnutrition
reactance
resistance
Descripción
Sumario:Although the need to assess hydration is well recognized, laboratory tests and clinical impressions are impractical and lack sensitivity, respectively, to be clinically meaningful. Different approaches use bioelectrical impedance measurements to overcome some of these limitations and aid in the classification of hydration status. One indirect approach utilizes single or multiple frequency bioimpedance in regression equations and theoretical models, respectively, with anthropometric measurements to predict fluid volumes (bioelectrical impedance spectroscopy-BIS) and estimate fluid overload based on the deviation of calculated to reference extracellular fluid volume. Alternatively, bioimpedance vector analysis (BIVA) uses direct phase-sensitive measurements of resistance and reactance, measured at 50 kHz, normalized for standing height, then plotted on a bivariate graph, resulting in a vector with length related to fluid content, and direction with phase angle that indexes hydration status. Comparison with healthy population norms enables BIVA to classify (normal, under-, and over-) and rank (change relative to pre-treatment) hydration independent of body weight. Each approach has wide-ranging uses in evaluation and management of clinical groups with over-hydration with an evolving emphasis on prognosis. This review discusses the advantages and limitations of BIS and BIVA for hydration assessment with comments on future applications.