Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study.
Assessment of fluid removal using ultrasound, bioimpedance and anthropometry in pediatric dialysis: a pilot study.
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DOI：
10.1186/s12882-022-03012-1
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发表时间：
2023-01-05
期刊：
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
--
作者：
在接受透析的儿童中，液体超载与发病率和死亡率有关。准确的临床评估是困难的，而且使用氧化氢(D2O)来测量全身水分(TBW)是不切实际的。我们研究了使用超声(US)、生物阻抗谱(BIS)和人体测量学来评估接受维持性血液透析(HD)的儿童的液体清除情况。参与者在HD前立即和HD后1-2小时完成US、BIS和人体测量，最多5次。超声测量下腔静脉直径、肺B线、肌肉弹性图和真皮厚度。BIS测量细胞外(ECF)和细胞内(ICF)液量。人体测量包括上臂中部、小腿和脚踝周长，以及三头肌皮褶厚度。透析前进行一次D2O治疗。我们评估了HD前后研究测量的变化，以及研究测量的变化与体重变化百分比(%∆BW)的相关性。我们还评估了BIS测量的TBW与D2O之间的一致性。共招募了8名年龄在3.4-18.5岁之间的参与者。对比HD前后的测量结果显示，下腔静脉直径、肺B型线、真皮厚度、BIS%ECF、上臂中段周长、脚踝和小腿周长均显著降低。重复测量相关分析显示，%∆BW与BISECF的变化(RRM值分别为0.5 1，95%CI0.0 4，0.80)和小腿围变化(RRM值分别为0.80，95%CI0.5 1，0.92)呈显著正相关。BIS总容重与D2O总容重相关，但L高估了总容重2.2%(95%LOA，-4.75%至0.42%)。BIS和小腿围可能有助于评估接受维持性HD的儿童体液状况的变化。下腔静脉直径、肺B线和真皮厚度是未来研究的潜在候选对象。网上版载有补充材料，可在10.1186/s12882-022-03012-1查阅。
Fluid overload is associated with morbidity and mortality in children receiving dialysis. Accurate clinical assessment is difficult, and using deuterium oxide (D2O) to measure total body water (TBW) is impractical. We investigated the use of ultrasound (US), bioimpedance spectroscopy (BIS), and anthropometry to assess fluid removal in children receiving maintenance hemodialysis (HD). Participants completed US, BIS, and anthropometry immediately before and 1–2 h after HD for up to five sessions. US measured inferior vena cava (IVC) diameter, lung B-lines, muscle elastography, and dermal thickness. BIS measured the volume of extracellular (ECF) and intracellular (ICF) fluid. Anthropometry included mid-upper arm, calf and ankle circumferences, and triceps skinfold thickness. D2O was performed once pre-HD. We assessed the change in study measures pre- versus post-HD, and the correlation of change in study measures with percent change in body weight (%∆BW). We also assessed the agreement between TBW measured by BIS and D2O. Eight participants aged 3.4–18.5 years were enrolled. Comparison of pre- and post-HD measures showed significant decrease in IVC diameters, lung B-lines, dermal thickness, BIS %ECF, mid-upper arm circumference, ankle, and calf circumference. Repeated measures correlation showed significant relationships between %∆BW and changes in BIS ECF (rrm =0.51, 95% CI 0.04, 0.80) and calf circumference (rrm=0.80, 95% CI 0.51, 0.92). BIS TBW correlated with D2O TBW but overestimated TBW by 2.2 L (95% LOA, -4.75 to 0.42). BIS and calf circumference may be helpful to assess changes in fluid status in children receiving maintenance HD. IVC diameter, lung B-lines and dermal thickness are potential candidates for future studies. The online version contains supplementary material available at 10.1186/s12882-022-03012-1.
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影响因子：
2.1
作者：
Kaptein MJ;Kaptein EM
通讯作者：
Kaptein EM
影响因子：
2.5
作者：
Park, S;Lake, ET
通讯作者：
Lake, ET
影响因子：
6.1
作者：
Krause, I;Birk, E;Eisenstein, B
通讯作者：
Eisenstein, B
影响因子：
3.4
作者：
BRAZZELLI, V;BORRONI, G;BERARDESCA, E
通讯作者：
BERARDESCA, E
影响因子：
1.9
作者：
Dahl, Helene;Warz, Sina-Isabel;Dierkes, Jutta
通讯作者：
Dierkes, Jutta