Castillo-Martínez Lilia, Bernal-Ceballos Fernanda, Reyes-Paz Yunuen, Hernández-Gilsoul Thierry
Clinical Nutrition Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán;
Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
J Vis Exp. 2022 Aug 17(186). doi: 10.3791/64331.
Early detection and management of fluid overload are critically important in acute illness, as the impact of therapeutic intervention can result in decreased or increased mortality rates. Accurate fluid status assessment entails appropriate therapy. Unfortunately, as the gold standard method of radioisotopic fluid measurement is costly, time-consuming, and lacks sensitivity in the acute care clinical setting, other less-accurate methods are typically used, such as clinical examination or 24 h output. Bioelectrical impedance vectorial analysis (BIVA) is an alternative impedance-based approach, where the raw parameter resistance and reactance of a subject are plotted to produce a vector, the position of which can be evaluated relative to tolerance intervals in an R-Xc graph. The fluid status is then interpreted as normal or abnormal, based on the distance from the mean vector derived from a healthy reference population. The objective of the present study is to demonstrate how to evaluate the presence of fluid overload through bioelectrical impedance vectorial analysis and the impedance ratio measured with tetrapolar multi-frequency equipment in patients admitted to the emergency department.
在急性疾病中，早期发现和处理液体超负荷至关重要，因为治疗干预的影响可能导致死亡率降低或升高。准确的液体状态评估需要适当的治疗。不幸的是，由于放射性同位素液体测量的金标准方法成本高、耗时，且在急性护理临床环境中缺乏敏感性，通常会使用其他不太准确的方法，如临床检查或24小时尿量。生物电阻抗矢量分析（BIVA）是一种基于阻抗的替代方法，将受试者的原始参数电阻和电抗绘制成矢量，其位置可在R-Xc图中相对于耐受区间进行评估。然后根据与健康参考人群得出的平均矢量的距离，将液体状态解释为正常或异常。本研究的目的是演示如何通过生物电阻抗矢量分析以及用四极多频设备测量的阻抗比来评估急诊科入院患者液体超负荷的存在情况。
