BIO ELECTRICAL IMPEDANCE ASSAY BIA: Dr Sidharta K Manggala (INTENSIVIST UNIV OF INDONESIA) скачать в хорошем качестве

BIO ELECTRICAL IMPEDANCE ASSAY BIA: Dr Sidharta K Manggala (INTENSIVIST UNIV OF INDONESIA)

00:00:00 intro 00:01:40 Principles of b i a 00:09:00 clinical uses 00:20:10 Fluid distribution in different scenarios 00:26:20 Indonesian study on b i a 00:36:20 case study Quick recap DR Sidharta discussed the use of Bioelectrical Impedance Analysis (BIA) in the ICU for assessing body composition and fluid balance, and its potential as a prognostic marker. He also highlighted the importance of understanding fluid balance in critically ill patients and the limitations of using BIA for fluid assessment. The discussion also covered the sequential measurement of a patient undergoing liver transplantation, the use of BIA in guiding fluid management during continuous renal replacement therapy, and the potential applications of BIA and related technologies in cardiac output monitoring and ARDS research. Summary BIA in ICU: Nutritional Assessment Sidharta presented on the Bioelectrical Impedance Analysis (BIA) in the ICU, a non-invasive method to assess body composition by measuring the resistance of body tissues to an electric current. BIA measures total body water, extra cellular water, and interactions, mainly used for nutritional assessment and fluid balance in the ICU. The device used is the Tatra Poller One, which is more accurate. The BIA can estimate the hydration status of a patient and is used in edema cases. The fat-free mass contains all the water, and understanding the composition is crucial for interpreting the results. Bi Technology in Lower-Middle Income Countries Sidharta discussed the benefits of using Bi technology in lower-middle income countries. It is inexpensive, requires only 8 electrodes, and does not involve radiation exposure. The technology can be used anywhere, including at a patient's bedside. Sidharta also highlighted the clinical use of Bi in ICU, including its use as a prognostic marker, assessing sarcopenia, and understanding fluid balance. He presented a study showing that a fast angle of 4.8 or below is associated with lower survival rates. Sidharta also discussed the use of Bi technology for monitoring nutrition, muscle mass, and detecting fluid imbalance. He concluded that Bi technology is a simple, non-invasive marker of cellular health and survival, and can be used to assess muscle mass and body composition. Fluid Balance in Critically Ill Patients Sidharta discussed the importance of understanding fluid balance in critically ill patients. He explained that the body is composed mainly of water, and its distribution is crucial for maintaining homeostasis. He highlighted that fluid imbalance can occur due to sepsis, capillary leak, and aggressive fluid resuscitation. Sidharta also discussed the limitations of using bioelectrical impedance analysis (BIA) for fluid assessment, including its inability to distinguish between vascular and interstitial fluid overload and its sensitivity to external factors. He emphasized the need for accurate assessment of fluid status to prevent fluid overload, guide diuresis, and support mechanical ventilation. Interpreting Data in Critically Ill Patients Sidharta discussed the importance of interpreting data cautiously, particularly in the context of critically ill patients. He highlighted the need for multi-frequency via for a foot compartment and the necessity of validation in IC populations and development of Iso-specific reference files. Sidharta also presented the results of a prospective bi study in Indonesia, which showed that non-survivors had more extracellular water, fluid excess, and volume excess compared to survivors. He concluded by emphasizing the prognostic ability of Bif parameters and the need for further research. Bia Measurement's Prognostic Value Sidharta discussed the sequential measurement of 7 days for a patient undergoing liver transplantation. He noted that the Bia measurement consistently calculated higher than the Cardex, attributing this to the Bia's ability to accurately measure total body water. Sidharta also presented the ROC curves for various measurements, highlighting that the Bia measurement had more prognostic value than the manual charting of fluid balance. He concluded by stating that a fluid overload of 4.32% calculated from the volume excess in liters divided by body weight could increase the mortality rate, emphasizing the need for careful monitoring of fluid balance in patients. BIA in ICU: Exploratory Tool He suggests measuring BIA on admission to establish a baseline and then as needed based on clinical questions or suspicions. Dr. Sidharta also explains how BIA can be helpful in guiding fluid management during continuous renal replacement therapy (CRRT). Dr. Tapes adds that BIA and related technologies like bioreactance and electrical impedance tomography are evolving areas with potential applications in cardiac output monitoring and ARDS research.