ASSESSMENT OF CHANGES IN BODY-WATER BY BIOIMPEDANCE IN ACUTELY ILL SURGICAL PATIENTS
ASSESSMENT OF CHANGES IN BODY-WATER BY BIOIMPEDANCE IN ACUTELY ILL SURGICAL PATIENTS
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DOI：
10.1007/bf01694359
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发表时间：
1992-10-01
影响因子：
38.9
通讯作者：
SCHUTZ, Y
中科院分区：
文献类型：
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作者：
CHIOLERO, RL;GAY, LJ;SCHUTZ, Y
目的：探讨外科急症患者在快速输注等渗盐水过程中0.5、50和kHz生物电阻抗(BI)的变化与体重变化的关系。设计：前瞻性临床研究。单位：一所大学医院的多学科外科ICU。患者：因急性外科疾病接受治疗的男性患者12例(多发伤5例，大手术7例)。选择标准：心血管参数稳定，心功能正常，低血容量体征(中心静脉压小于或等于5毫米汞柱，尿量<1ml/kg×h)。干预：基线测量结束后，用0.25ml/kg生理盐水进行60min液体激发试验。测量和结果：体重(平台数字秤)、全身阻抗(四表面电极技术；在0.5、50和100 kHz下测量)和尿量。液体滞留导致0.5、50和100 kHz的BI进行性下降，但从开始液体治疗的40min开始，BI 0.5和BI 100的变化才显著。土壤持水变化与BI0.5呈显著负相关，个体相关系数为-0.72~0.95(p<；0.01~0.0001)。回归线的斜率表明，每改变一公斤水，BI平均减少18欧姆，但注意到显著的个体间差异。结论：低频率测量的BI可以代表一组外科患者体内水分急性变化的有价值的指标，而不是特定的个体。
Objective: To evaluate the relationship between changes in body bioelectrical impedance (BI) at 0.5, 50 and kHz and the changes in body weight, as an index of total body water changes, in acutely ill surgical patients during the rapid infusion of isotonic saline solution. Design: Prospective clinical study. Setting: Multidisciplinary surgical ICU in a university hospital. Patients: Twelve male patients treated for acute surgical illness (multiple trauma n = 5, major surgery n = 7). Selection criteria: stable cardiovascular parameters, normal cardiac function, signs of hypovolemia (CVP less-than-or-equal-to 5 mmHg, urine ouput < 1 ml/kg x h). Interventions: After baseline measurements, a 60 min fluid challenge test was performed with normal saline solution, 0.25 ml/kg. Measurements and results: Body weight (platform digital scale), total body impedance (four-surface electrode technique; measurements at 0.5, 50 and 100 kHz) and urine output. Fluid retention induced a progressive decrease in BI at 0.5, 50 and 100 kHz, but the changes were significant for BI 0.5 and BI 100 only, from 40 min after the beginning of the fluid therapy onwards. There was a significant negative correlation between changes in water retention and BI 0.5, with individual correlation coefficients ranging from -0.72 to 0.95 (p < 0.01-0.0001). The slopes of the regression lines indicated that for each kg of water change, there was a mean decrease in BI of 18 ohm, but a substantial inter-individual variability was noted. Conclusion: BI measured at low frequency can represent a valuable index of acute changes in body water in a group of surgical patients but not in a given individual