Ismail Abdul Hamid, Schlieper Georg, Walter Marian, Floege Jürgen, Leonhardt Steffen
Chair for Medical Information Technology, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, Aachen, Germany.
Department of Nephrology and Immunology (Medical Clinic II), RWTH Aachen University Hospital, Pauwelsstr. 30, Aachen, Germany.
J Electr Bioimpedance. 2019 Aug 20;10(1):55-62. doi: 10.2478/joeb-2019-0008. eCollection 2019 Jan.
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 (R) and R normalized for ultrafiltration volume (ΔR/UFV) with < 0.001 was observed. The relationship between relative change (%) in ΔR 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.
生物阻抗光谱（BIS）技术用于监测透析过程中体液变化的可行性正在提高。本研究的目的是比较膝对膝生物阻抗光谱法（kkBIS）与传统的全身生物阻抗光谱法（whBIS）在持续评估血液透析患者体液容量状态方面的差异。招募了20名患者，分为血流动力学稳定和不稳定两组。收集并回顾性分析了来自两种不同电极配置（手到脚和膝到膝）的生物阻抗数据。观察到两种方法在细胞外电阻（R）变化以及超滤量标准化后的R（ΔR/UFV）方面具有良好的相关性，P<0.001。与whBIS（3.69±2.90%/kg）相比，kkBIS（4.82±3.31%/kg）在不稳定患者中，ΔR的相对变化（%）与患者体重的相对变化之间的关系最为显著。此外，基于kkBIS的结果显示，不稳定患者大腿部位跟上躯干容量变化的能力降低。即使在有透析中低血压风险的患者中，kkBIS也能提供与whBIS相当的敏感性，同时避免了whBIS或其他配置所带来的复杂操作要求。
