Author/Authors :
Rochwerg, Bram Department of Medicine - McMaster University, Hamilton, Canada , Cheung, Jason H. Department of Medicine - McMaster University, Hamilton, Canada , Ribic, Christine M. Department of Medicine - McMaster University, Hamilton, Canada , Lalji, Faraz Division of Nephrology, St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Clarke, France J. Department of Clinical Epidemiology and Biostatistics - McMaster University, Hamilton, Canada , Gantareddy, Susheel Department of Family Medicine - Northern Ontario School of Medicine, Sudbury, Canada , Ranganath, Nischal Department of Medicine - McMaster University, Hamilton, Canada , Walele, Aziz Brampton Civic Hospital, Brampton, Canada , McDonald, Ellen Department of Medicine - McMaster University, Hamilton, Canada , Meade, Maureen O. Department of Medicine - McMaster University, Hamilton, Canada , Cook, Deborah J. Department of Medicine - McMaster University, Hamilton, Canada , Wilkieson, Trevor T. Division of Nephrology, St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Clase, Catherine M. Department of Medicine - McMaster University, Hamilton, Canada , Margetts, Peter J. Department of Medicine - McMaster University, Hamilton, Canada , Gangji, Azim S. Department of Medicine - McMaster University, Hamilton, Canada
Abstract :
Background. Bioimpedance analysis (BIA) is a novel method of assessing a patient’s volume status. Objective.We sought to determine
the feasibility of using vector length (VL), derived from bioimpedance analysis (BIA), in the assessment of postresuscitation volume
status in intensive care unit (ICU) patients with sepsis. Method. This was a prospective observational single-center study. Our
primary outcome was feasibility. Secondary clinical outcomes included ventilator status and acute kidney injury. Proof of concept
was sought by correlating baseline VL measurements with other known measures of volume status. Results. BIA was feasible to
perform in the ICU. We screened 655 patients, identified 78 eligible patients, and approached 64 for consent. We enrolled 60
patients (consent rate of 93.8%) over 12 months. For each 50-unit increase in VL, there was an associated 22% increase in the
probability of not requiring invasive mechanical ventilation (IMV) (𝑝 = 0.13). Baseline VL correlated with other measures of
volume expansion including serum pro-BNP levels, peripheral edema, and central venous pressure (CVP). Conclusion. It is feasible
to use BIA to predict postresuscitation volume status and patient-important outcomes in septic ICU patients. Trial Registration.
This trial is registered with clinicaltrials.gov NCT01379404 registered on June 7, 2011.
