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Segmental bioelectrical impedance analysis to assess perioperative fluid changes

Bracco, David MD; Berger, Mette M. MD, PhD; Revelly, Jean-Pierre MD; Schütz, Yves PhD; Frascarolo, Philippe PhD; Chioléro, René MD

Clinical Investigations
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Objectives Perioperative fluid accumulation determination is a challenge for the clinician. Bioelectrical impedance analysis (BIA) is a noninvasive method based on the electrical properties of tissues, which can assess body fluid compartments. The study aimed at assessing their changes in three types of surgery (thoracic, abdominal, and intracranial) requiring various regimens of fluid administration.

Design Prospective descriptive trial.

Patients A total of 26 patients scheduled for elective surgery were separated into three groups according to site of surgery: thoracic (n = 8), abdominal aortic (n = 8), and brain surgery (n = 10).

Setting University teaching hospital.

Intervention None.

Measurements Whole body, segmental (arm, trunk, and legs) BIA at multiple frequency (0.5, 50, 100 kHz) was used to assess perioperative fluid accumulation after surgery. The fluid balances were calculated from the charts.

Results The patients were aged 62 ± 4 yrs. Fluid balances were 4.8 ± 1.0 L, 4.1 ± 0.5 L, and 1.9 ± 0.3 L, respectively, in the three groups. In trunk surgery patients, fluid accumulation was detected as a drop in impedance in the operated area at all frequencies. In the operated area, there was an expansion of both intra- and extracellular compartments. A reduction in high frequencies’ impedance in the legs was only detected after aortic surgery. Fluid accumulation and trunk impedance changes were strongly correlated. Neurosurgery only induced minor body fluid changes.

Conclusions Segmental BIA is able to detect and localize perioperative fluid accumulation. It may become a bedside tool to quantify and to localize fluid accumulation.

From the Surgical Intensive Care Unit (Drs. Bracco, Berger, Revelly, Chioléro) and the Department of Anesthesiology (Dr. Frascarolo), University Hospital, and the Institute of Physiology, Faculty of Medicine, University of Lausanne (Dr. Schütz), Lausanne, Switzerland.

Supported, in part, by the fund of the Anesthesiology-Surgical ICU Department.

Address requests for reprints to: Mette M. Berger, MD, PhD, Surgical Intensive Care Unit, BH-08.660, CHUV, CH - 1011 Lausanne, Switzerland. E-mail: Mette.Berger @chuv.hospvd.ch

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