Hanna Daniel, Baig Iftekhar, Subbiondo Robert, Iqbal Umair
Internal Medicine, Hospital Corporation of America (HCA) Blake Florida, Bradenton, USA.
Cardiology, Hospital Corporation of America (HCA) Blake Florida, Bradenton, USA.
Cureus. 2023 Apr 10;15(4):e37377. doi: 10.7759/cureus.37377. eCollection 2023 Apr.
Bioelectrical impedance analysis (BIA) is a method that measures electrical currents conducted through water, which assesses fluid status by measuring extracellular water (ECW), total body water (TBW), and resistance (R). Limited studies are done to evaluate the utility of BIA in patients with congestive heart failure (CHF), and therefore, we performed a systematic review and meta-analysis to evaluate this. A comprehensive literature search was performed at Medline and Embase until March 2022. Our primary outcome was a comparison of TBW and ECW between patients with CHF and controls. Our secondary outcome was to compare R between the groups. All analysis was conducted using RevMan 5.4 software. Six studies with 1,046 patients met our inclusion criteria. Out of 1,046 patients, 526 had CHF and 538 had no CHF. Among patients with CHF, all 526 had decompensated CHF. There was no significant difference in TBW between patients with heart failure and the control group (mean deviation (MD) = 1.42 (-0.44-3.27), percent of variation (I2) = 0%, p = 0.13). ECW was significantly higher with an assessment of BIA in heart failure patients compared to patients in the control group (MD = 1.62 (0.82-2.42), I2 = 0%, p < 0.0001). Resistance of extracellular fluid was significantly lower in the heart failure group (MD = -45.64 (-72.88--18.41), I2 = 83%, p = 0.001). Publication bias was deferred as the number of included studies was less than 10. BIA can be helpful in ambulatory and inpatient setting to identify patients' fluid status, which can improve outcomes. However, larger prospective studies are needed to further evaluate the usefulness of BIA in the CHF population.
生物电阻抗分析（BIA）是一种测量通过水传导的电流的方法，它通过测量细胞外液（ECW）、总体液（TBW）和电阻（R）来评估液体状态。评估BIA在充血性心力衰竭（CHF）患者中的效用的研究有限，因此，我们进行了一项系统评价和荟萃分析来评估这一点。在Medline和Embase上进行了全面的文献检索，直至2022年3月。我们的主要结局是比较CHF患者和对照组之间的TBW和ECW。我们的次要结局是比较两组之间的R。所有分析均使用RevMan 5.4软件进行。六项研究共1046例患者符合我们的纳入标准。在1046例患者中，526例患有CHF，538例没有CHF。在CHF患者中，所有526例均为失代偿性CHF。心力衰竭患者和对照组之间的TBW没有显著差异（平均偏差（MD）=1.42（-0.44 - 3.27），变异百分比（I2）=0%，p = 0.13）。与对照组患者相比，心力衰竭患者通过BIA评估的ECW显著更高（MD = 1.62（0.82 - 2.42），I2 = 0%，p < 0.0001）。心力衰竭组细胞外液的电阻显著更低（MD = -45.64（-72.88 - -18.41），I2 = 83%，p = 0.001）。由于纳入研究的数量少于10项，因此未评估发表偏倚。BIA有助于在门诊和住院环境中识别患者的液体状态，这可以改善预后。然而，需要更大规模的前瞻性研究来进一步评估BIA在CHF人群中的效用。
