Claire E Baldwin1, Kate Fetterplace2,3, Lisa Beach2, Geetha Kayambu4, Jennifer Paratz5,6, Carrie Earthman7, Selina M Parry8. 1. College of Nursing and Health Sciences and College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia. 2. Department of Allied Health, Melbourne Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. 3. Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia. 4. National University Hospital, Singapore, Singapore. 5. Royal Brisbane and Women's Hospital, Nathan, Queensland, Australia. 6. Griffith University, Nathan, Queensland, Australia. 7. Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA. 8. Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: The potential for bioimpedance spectroscopy (BIS) to identify muscle weakness and functional limitations in critical illness is unknown; this study aimed to determine association of BIS with strength/function and differences between 3 intensive care units (ICUs). METHODS: A retrospective post hoc analysis of BIS, strength, and functional data from adults who required ≥48 hours of mechanical ventilation was conducted. Measures of body composition included the proportion (%) of total body water (TBW), fat mass (FM), and fat-free mass (FFM). The Medical Research Council sum score (MRC-ss) and Physical Function in ICU Test-Scored (PFIT-s) were used for strength and functional assessments. Nonparametric cross-sectional analyses were done at enrollment (≤48 hours of admission: site-A, site-C) and awakening from sedation (site-A, site-B). Raw impedance variables including 50-kHz phase angle (PA) and impedance ratio (IR) were available from site-A and site-B. RESULTS: Participants were 135 adults (site-A n=59, site-B n=33, site-C n=44), with a median (interquartile range) age of 59 (50-69) years. At enrollment, TBW%, FM%, and FFM% were similar between site-A and site-C (P>.05); pooled data were not associated with MRC-ss at awakening or MRC-ss/PFIT-s at ICU discharge. At awakening, there was less TBW%, less FFM%, and greater FM% at site-B vs site-A (P≤.001) but no associations with MRC-ss/PFIT-s when using pooled data. Trends with pooled data of a lower PA and higher IR being associated with awakening MRC-ss were confirmed within site-B (PA ρ=0.70, P≤.001; IR ρ=-0.79, P≤.001). CONCLUSION: Site-by-site data suggest that raw impedance variables might be useful for screening weakness and poor function.
BACKGROUND: The potential for bioimpedance spectroscopy (BIS) to identify muscle weakness and functional limitations in critical illness is unknown; this study aimed to determine association of BIS with strength/function and differences between 3 intensive care units (ICUs). METHODS: A retrospective post hoc analysis of BIS, strength, and functional data from adults who required ≥48 hours of mechanical ventilation was conducted. Measures of body composition included the proportion (%) of total body water (TBW), fat mass (FM), and fat-free mass (FFM). The Medical Research Council sum score (MRC-ss) and Physical Function in ICU Test-Scored (PFIT-s) were used for strength and functional assessments. Nonparametric cross-sectional analyses were done at enrollment (≤48 hours of admission: site-A, site-C) and awakening from sedation (site-A, site-B). Raw impedance variables including 50-kHz phase angle (PA) and impedance ratio (IR) were available from site-A and site-B. RESULTS:Participants were 135 adults (site-A n=59, site-B n=33, site-C n=44), with a median (interquartile range) age of 59 (50-69) years. At enrollment, TBW%, FM%, and FFM% were similar between site-A and site-C (P>.05); pooled data were not associated with MRC-ss at awakening or MRC-ss/PFIT-s at ICU discharge. At awakening, there was less TBW%, less FFM%, and greater FM% at site-B vs site-A (P≤.001) but no associations with MRC-ss/PFIT-s when using pooled data. Trends with pooled data of a lower PA and higher IR being associated with awakening MRC-ss were confirmed within site-B (PA ρ=0.70, P≤.001; IR ρ=-0.79, P≤.001). CONCLUSION: Site-by-site data suggest that raw impedance variables might be useful for screening weakness and poor function.
Authors: Carmen Rosa Hernández-Socorro; Pedro Saavedra; Juan Carlos López-Fernández; Federico Lübbe-Vazquez; Sergio Ruiz-Santana Journal: Nutrients Date: 2021-06-29 Impact factor: 5.717