Bioimpedance at the bedside: current applications, limitations, and opportunities.
Identifieur interne : 001076 ( PubMed/Corpus ); précédent : 001075; suivant : 001077Bioimpedance at the bedside: current applications, limitations, and opportunities.
Auteurs : Urvashi Mulasi ; Adam J. Kuchnia ; Abigail J. Cole ; Carrie P. EarthmanSource :
- Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [ 1941-2452 ] ; 2015.
English descriptors
- KwdEn :
- Body Composition, Electric Impedance, Electrodes, Extracellular Fluid (physiology), Humans, Lymphedema (diagnosis), Nutrition Assessment, Nutritional Status, Plethysmography, Impedance (instrumentation), Plethysmography, Impedance (methods), Renal Dialysis, Signal Processing, Computer-Assisted (instrumentation), Spectrum Analysis (instrumentation), Spectrum Analysis (methods).
- MESH :
- diagnosis : Lymphedema.
- instrumentation : Plethysmography, Impedance, Signal Processing, Computer-Assisted, Spectrum Analysis.
- methods : Plethysmography, Impedance, Spectrum Analysis.
- physiology : Extracellular Fluid.
- Body Composition, Electric Impedance, Electrodes, Humans, Nutrition Assessment, Nutritional Status, Renal Dialysis.
Abstract
The loss of muscle mass is a defining characteristic of malnutrition, and there is ongoing interest in the assessment of lean tissue at the bedside. Globally, bioimpedance techniques have been widely appreciated for their noninvasiveness, safety, ease of use, portability, and relatively low cost compared with other clinically available methods. In this brief update, we review the 3 primary types of commercially available bioimpedance devices (single- and multiple-frequency and spectroscopy) and differentiate the underlying theory and current applications of each. We also address limitations and potential opportunities for using these devices at the bedside for clinical assessment. Mixed reports in the validation literature for all bioimpedance approaches have raised questions about absolute accuracy to estimate whole body composition in clinical populations, particularly those with abnormal fluid status and/or body geometry in whom underlying method assumptions may be violated. Careful selection of equations can improve whole body estimates by single- and multiple-frequency techniques; however, not all devices will allow for this approach. Research is increasing on the use of bioimpedance variables including phase angle and impedance ratio as potential markers of nutrition status and/or clinical outcomes; consensus on reference cut-points for interpreting these markers has yet to be established. Novel developments in the bioimpedance spectroscopy approach are allowing for improved fluid management in individuals receiving dialysis; these developments have implications for the clinical management of other conditions associated with fluid overload and may also provide enhanced whole body estimates of lean tissue through new modeling procedures.
DOI: 10.1177/0884533614568155
PubMed: 25613832
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pubmed:25613832Le document en format XML
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Cole</name><affiliation><nlm:affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota.</nlm:affiliation></affiliation></author><author><name sortKey="Earthman, Carrie P" sort="Earthman, Carrie P" uniqKey="Earthman C" first="Carrie P" last="Earthman">Carrie P. 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Kuchnia</name><affiliation><nlm:affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota.</nlm:affiliation></affiliation></author><author><name sortKey="Cole, Abigail J" sort="Cole, Abigail J" uniqKey="Cole A" first="Abigail J" last="Cole">Abigail J. Cole</name><affiliation><nlm:affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota.</nlm:affiliation></affiliation></author><author><name sortKey="Earthman, Carrie P" sort="Earthman, Carrie P" uniqKey="Earthman C" first="Carrie P" last="Earthman">Carrie P. Earthman</name><affiliation><nlm:affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota cearthma@umn.edu.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition</title><idno type="eISSN">1941-2452</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Body Composition</term><term>Electric Impedance</term><term>Electrodes</term><term>Extracellular Fluid (physiology)</term><term>Humans</term><term>Lymphedema (diagnosis)</term><term>Nutrition Assessment</term><term>Nutritional Status</term><term>Plethysmography, Impedance (instrumentation)</term><term>Plethysmography, Impedance (methods)</term><term>Renal Dialysis</term><term>Signal Processing, Computer-Assisted (instrumentation)</term><term>Spectrum Analysis (instrumentation)</term><term>Spectrum Analysis (methods)</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Plethysmography, Impedance</term><term>Signal Processing, Computer-Assisted</term><term>Spectrum Analysis</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Plethysmography, Impedance</term><term>Spectrum Analysis</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Extracellular Fluid</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Body Composition</term><term>Electric Impedance</term><term>Electrodes</term><term>Humans</term><term>Nutrition Assessment</term><term>Nutritional Status</term><term>Renal Dialysis</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The loss of muscle mass is a defining characteristic of malnutrition, and there is ongoing interest in the assessment of lean tissue at the bedside. Globally, bioimpedance techniques have been widely appreciated for their noninvasiveness, safety, ease of use, portability, and relatively low cost compared with other clinically available methods. In this brief update, we review the 3 primary types of commercially available bioimpedance devices (single- and multiple-frequency and spectroscopy) and differentiate the underlying theory and current applications of each. We also address limitations and potential opportunities for using these devices at the bedside for clinical assessment. Mixed reports in the validation literature for all bioimpedance approaches have raised questions about absolute accuracy to estimate whole body composition in clinical populations, particularly those with abnormal fluid status and/or body geometry in whom underlying method assumptions may be violated. Careful selection of equations can improve whole body estimates by single- and multiple-frequency techniques; however, not all devices will allow for this approach. Research is increasing on the use of bioimpedance variables including phase angle and impedance ratio as potential markers of nutrition status and/or clinical outcomes; consensus on reference cut-points for interpreting these markers has yet to be established. Novel developments in the bioimpedance spectroscopy approach are allowing for improved fluid management in individuals receiving dialysis; these developments have implications for the clinical management of other conditions associated with fluid overload and may also provide enhanced whole body estimates of lean tissue through new modeling procedures.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25613832</PMID><DateCreated><Year>2015</Year><Month>04</Month><Day>01</Day></DateCreated><DateCompleted><Year>2015</Year><Month>12</Month><Day>30</Day></DateCompleted><DateRevised><Year>2015</Year><Month>04</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1941-2452</ISSN><JournalIssue CitedMedium="Internet"><Volume>30</Volume><Issue>2</Issue><PubDate><Year>2015</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition</Title><ISOAbbreviation>Nutr Clin Pract</ISOAbbreviation></Journal><ArticleTitle>Bioimpedance at the bedside: current applications, limitations, and opportunities.</ArticleTitle><Pagination><MedlinePgn>180-93</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1177/0884533614568155</ELocationID><Abstract><AbstractText>The loss of muscle mass is a defining characteristic of malnutrition, and there is ongoing interest in the assessment of lean tissue at the bedside. Globally, bioimpedance techniques have been widely appreciated for their noninvasiveness, safety, ease of use, portability, and relatively low cost compared with other clinically available methods. In this brief update, we review the 3 primary types of commercially available bioimpedance devices (single- and multiple-frequency and spectroscopy) and differentiate the underlying theory and current applications of each. We also address limitations and potential opportunities for using these devices at the bedside for clinical assessment. Mixed reports in the validation literature for all bioimpedance approaches have raised questions about absolute accuracy to estimate whole body composition in clinical populations, particularly those with abnormal fluid status and/or body geometry in whom underlying method assumptions may be violated. Careful selection of equations can improve whole body estimates by single- and multiple-frequency techniques; however, not all devices will allow for this approach. Research is increasing on the use of bioimpedance variables including phase angle and impedance ratio as potential markers of nutrition status and/or clinical outcomes; consensus on reference cut-points for interpreting these markers has yet to be established. Novel developments in the bioimpedance spectroscopy approach are allowing for improved fluid management in individuals receiving dialysis; these developments have implications for the clinical management of other conditions associated with fluid overload and may also provide enhanced whole body estimates of lean tissue through new modeling procedures.</AbstractText><CopyrightInformation>© 2015 American Society for Parenteral and Enteral Nutrition.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mulasi</LastName><ForeName>Urvashi</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kuchnia</LastName><ForeName>Adam J</ForeName><Initials>AJ</Initials><AffiliationInfo><Affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cole</LastName><ForeName>Abigail J</ForeName><Initials>AJ</Initials><AffiliationInfo><Affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Earthman</LastName><ForeName>Carrie P</ForeName><Initials>CP</Initials><AffiliationInfo><Affiliation>Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, Minnesota cearthma@umn.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>01</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Nutr Clin Pract</MedlineTA><NlmUniqueID>8606733</NlmUniqueID><ISSNLinking>0884-5336</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CitationSubset>N</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="ErratumIn"><RefSource>Nutr Clin Pract. 2015 Aug;30(4):589</RefSource><PMID Version="1">26206955</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D001823" MajorTopicYN="Y">Body Composition</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017097" MajorTopicYN="Y">Electric Impedance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004566" MajorTopicYN="Y">Electrodes</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D045604" MajorTopicYN="N">Extracellular Fluid</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015596" MajorTopicYN="N">Nutrition Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009752" MajorTopicYN="N">Nutritional Status</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010992" MajorTopicYN="N">Plethysmography, Impedance</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006435" MajorTopicYN="N">Renal Dialysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012815" MajorTopicYN="N">Signal Processing, Computer-Assisted</DescriptorName><QualifierName UI="Q000295" 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