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Knee-to-knee bioimpedance measurements to monitor changes in extracellular fluid in haemodynamic-unstable patients during dialysis

Authors
  • Ismail, Abdul Hamid
  • Schlieper, Georg
  • Walter, Marian
  • Floege, Jürgen
  • Leonhardt, Steffen
Type
Published Article
Journal
Journal of Electrical Bioimpedance
Publisher
Sciendo
Publication Date
Aug 20, 2019
Volume
10
Issue
1
Pages
55–62
Identifiers
DOI: 10.2478/joeb-2019-0008
Source
De Gruyter
Keywords
License
Green

Abstract

The feasibility of bioimpedance spectroscopy (BIS) techniques for monitoring intradialytic changes in body fluids is advancing. The aim of this study was to compare the knee-to-knee (kkBIS) with the traditional whole-body (whBIS) with respect to continuous assessment of fluid volume status in hemodialysis patients. Twenty patients divided into two groups, hemodynamically stable and unstable, were recruited. Bioimpedance data from two different electrodes configurations (hand-to-foot and knee-to-knee) were collected and retrospectively analysed. A good correlation between the two methods with respect to changes in extracellular resistance (Re) and Re normalized for ultrafiltration volume (ΔRe/UFV) with p < 0.001 was observed. The relationship between relative change (%) in ΔRe and that in patient weight was most notable with kkBIS (4.82 ± 3.31 %/kg) in comparison to whBIS (3.69 ± 2.90 %/kg) in unstable patients. Furthermore, results based on kkBIS showed a reduced ability of the thigh compartments to keep up with the volume changes in the trunk for unstable patients. kkBIS provided a comparable sensitivity to whBIS even in patients at risk of intradialytic hypotension while avoiding the need for the complex implementation imposed by whBIS or other configurations.

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