Bioimpedance as a measure of fluid status in critically ill patients: A systematic review

Autor:	Janne M. Madsen, Morten H. Bestle, Sine Wichmann, Theis Skovsgaard Itenov
Rok vydání:	2021
Předmět:	Adult medicine.medical_specialty Critical Illness law.invention 03 medical and health sciences 0302 clinical medicine law Intensive care medicine Humans 030212 general & internal medicine Intensive care medicine Reproducibility Measure (data warehouse) business.industry Critically ill Reproducibility of Results 030208 emergency & critical care medicine General Medicine Gold standard (test) Intensive care unit Intensive Care Units Anesthesiology and Pain Medicine Data extraction Fluid Therapy business Bioelectrical impedance analysis
Zdroj:	Acta Anaesthesiologica Scandinavica. 65:1155-1167
ISSN:	1399-6576 0001-5172
DOI:	10.1111/aas.13924
Popis:	OBJECTIVE Precise measurements of fluid status lack valid methods. Bioimpedance is an attractive diagnostic tool because it is noninvasive, quick, and relatively cheap. This systematic review aims to assess the existing evidence of bioimpedance as an accurate measure of fluid status in critically ill patients. DATA SOURCES PubMed and Embase up till March 2021 were systematically searched (PROSPERO: CRD42020157436). STUDY SELECTION Eligibility criteria were studies reporting original data from cohorts of adult patients in intensive care units and doing at least one whole-body bioimpedance and one reference test. In addition, studies assessing internal reproducibility were included. DATA EXTRACTION An extraction form was designed for the purpose. DATA SYNTHESIS Nine hundred five studies were screened for eligibility, and 28 studies, comprising 1482 individual patients, were included in the final analysis. Eight studies compared bioimpedance with a gold standard, and two of those reported the results adequate. We found a low mean difference, but the 95% limits of agreements had wide limits. The remaining studies applied different surrogates as reference tests. Correlations ranged from 0.05 to 0.99. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty of evidence for all outcomes was very low. CONCLUSIONS The accuracy of bioimpedance as a measure for fluids in critically ill patients in the intensive care unit cannot be determined. Due to the lack of a gold standard, numerous studies compared bioimpedance with surrogate outcomes with great variability in both designs and results. Assessing the internal reproducibility of bioimpedance had the same limitations, but the studies overall reported good internal reproducibility.
Databáze:	OpenAIRE
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