Showing papers on "Body water published in 2016"
TL;DR: This review is focused on the use of Body Composition in Clinical Practice, and shows the need to find a better way to evaluate body composition, in order to assess fat-free and fat mass with weight gain and loss, and during ageing.
146 citations
TL;DR: In this paper, the influence of a Mediterranean dietary pattern (MeDiet) on anthropometric and body composition parameters in one of the centers of the PREDIMED randomized dietary trial was assessed.
Abstract: Objective: To assess the influence of a Mediterranean dietary pattern (MeDiet) on anthropometric and body composition parameters in one of the centers of the PREDIMED randomized dietary trial.Subjects/Settings: 351 Canarian free-living subjects aged 55 to 80 years, with type 2 diabetes or ≥3 cardiovascular risk factors.Intervention: Participants were randomly assigned to one of 3 different dietary interventions: MeDiet + extra-virgin olive oil (EVOO), MeDiet + nuts (walnuts, almonds, and hazelnuts), or a control low-fat diet. Total energy intake was ad libitum.Outcome measures: Measures included changes in anthropometric measures (weight, body mass index [BMI] and waist circumference [WC]), body fat distribution, energy, and nutrient intake after 1 year. Body composition (percentage of total body fat [%TBF], total fat mass [TFM], free fat mass [FFM], percentage of truncal fat [%TrF], truncal fat mass [TrFM]) and total body water (TBW) were estimated by octapolar electrical impedance analysis.Statistical a...
98 citations
TL;DR: Higher convection volumes were generally associated with greater survival benefit with OL-HDF, but results varied across different ways of standardization for body size, so further studies should take body size into account when evaluating the impact of delivered convection volume on mortality end points.
88 citations
TL;DR: Thigh ECW/ICW was a significant predictor of knee extension strength and gait speed independent of age, sex, body mass index, and skeletal muscle mass and relative expansion of ECW against ICW in the thigh muscles is a factor in decreased muscle quality and a biomarker of muscle aging.
Abstract: Skeletal muscles contain a large volume of water that is classified into intracellular (ICW) and extracellular (ECW) water fractions. Nuclear magnetic resonance-based biomarkers suggest that increased water T2 heterogeneities, as well as elevated water T2 relaxation in the quadriceps occurs in the elderly when compared with young adults. However, nuclear magnetic resonance is difficult to apply to a large-scale study or a clinical setting for sarcopenia and frailty screening. Segmental bioelectrical impedance spectroscopy is a unique tool used to assess the segmental ratio of ECW/ICW in the limbs. We evaluated 405 community-living people aged between 65 and 90 years. ECW and ICW in the upper legs were assessed by segmental bioelectrical impedance spectroscopy. Isometric knee extension strength, gait speed, and skeletal muscle mass were measured. Thigh ECW/ICW was negatively correlated with knee extension strength and gait speed (r = -.617 and -.431, respectively, p < .001) and increased with age (p < .001). Thigh ECW/ICW was a significant predictor of knee extension strength and gait speed independent of age, sex, body mass index, and skeletal muscle mass. Relative expansion of ECW against ICW in the thigh muscles is a factor in decreased muscle quality and a biomarker of muscle aging.
66 citations
TL;DR: The new BIA-based models developed based on dilution methods based on deuterium dilution can be considered valid, with no observed bias, thus affording practical means to quantify TBW and ECW in national level athletes.
61 citations
TL;DR: In this article, the relationship between gestational weight gain and maternal fat and lean body mass accrual was quantified and compared according to the 2009 Institute of Medicine Guidelines for Gestational Weight Gain in Pregnancy adherence.
53 citations
TL;DR: This study indicated that LPD slows down the progression of kidney disease but worsens patients' nutritional state, possibly connected to protein-energy wasting.
Abstract: Chronic kidney disease (CKD) is becoming increasingly widespread in the world. Slowing its progression means to prevent uremic complications and improve quality of life of patients. Currently, a low-protein diet (LPD) is one of the tools most used in renal conservative therapy but a possible risk connected to LPD is protein-energy wasting. The aim of this study is evaluate the possible correlation between LPD and malnutrition onset. We enrolled 41 CKD patients, stages IIIb/IV according to K-DIGO guidelines, who followed for 6 weeks a diet with controlled protein intake (recommended dietary allowance 0.7 g per kilogram Ideal Body Weight per day of protein). Our patients showed a significant decrease of serum albumin values after 6 weeks of LDP (T2) compared with baseline values (T0) (P=0.039), whereas C-reactive protein increased significantly (T0 versus T2; P=0.131). From body composition analysis, a significant impairment of fat-free mass percentage at the end of the study was demonstrated (T0 versus T2; P=0.0489), probably related to total body water increase. The muscular mass, body cell mass and body cell mass index are significantly decreased after 6 weeks of LDP (T2). The phase angle is significantly reduced at the end of the study compared with basal values (T0 versus T2; P=0.0001, and T1 versus T2; P=0.0015). This study indicated that LPD slows down the progression of kidney disease but worsens patients' nutritional state.
45 citations
TL;DR: ADP that uses gestational age-specific equations may provide a reasonable and practical measurement of maternal FM across a spectrum of body weights in late pregnancy.
44 citations
TL;DR: It is suggested that increase in body water after carbohydrate loading can be detected by BIS and is caused by segment-specific increases in ICW.
Abstract: Body water content increases during carbohydrate loading because 2.7-4-g water binds each 1 g of glycogen. Bioelectrical impedance spectroscopy (BIS) allows separate assessment of extracellular and intracellular water (ECW and ICW, respectively) in the whole body and each body segment. However, BIS has not been shown to detect changes in body water induced by carbohydrate loading. Here, we aimed to investigate whether BIS had sufficient sensitivity to detect changes in body water content and to determine segmental water distribution after carbohydrate loading. Eight subjects consumed a high-carbohydrate diet containing 12 g carbohydrates·kg body mass(-1)·day(-1) for 72 h after glycogen depletion cycling exercise. Changes in muscle glycogen concentration were measured by (13)C-magnetic resonance spectroscopy, and total body water (TBW) was measured by the deuterium dilution technique (TBWD2O). ICW and ECW in the whole body (wrist-to-ankle) and in each body segment (arm, trunk, and leg) were assessed by BIS. Muscle glycogen concentration [72.7 ± 10.0 (SD) to 169.4 ± 55.9 mmol/kg wet wt, P < 0.001] and TBWD2O (39.3 ± 3.2 to 40.2 ± 3.0 kg, P < 0.05) increased significantly 72 h after exercise compared with baseline, respectively. Whole-body BIS showed significant increases in ICW (P < 0.05), but not in ECW. Segmental BIS showed significant increases in ICW in the legs (P < 0.05), but not in the arms or trunk. Our results suggest that increase in body water after carbohydrate loading can be detected by BIS and is caused by segment-specific increases in ICW.
42 citations
TL;DR: Routine use of longitudinal BI vector plots to improve clinical management of fluid status is not supported and Clinicians in the United Kingdom reduced target weight in the nonanuric BI intervention group causing a reduction in TBW without beneficial effects on ECW or blood pressure.
42 citations
TL;DR: Both perspectives of fluid intake adequacy are discussed in detail and a simple tool is reviewed that may help healthy, active, low-risk populations answer the question, “Am I drinking enough?”
Abstract: Adequate fluid intake can be dually defined as a volume of fluid (from water, beverages, and food) sufficient to replace water losses and provide for solute excretion. A wide range of fluid intakes are compatible with euhydration, whereby total body water varies narrowly from day to day by 600 to 900 mL (<1% body mass). One measure of fluid intake adequacy involves enough fluid to prevent meaningful body water deficits outside this euhydration range (i.e., dehydration). Another measure of fluid intake adequacy involves enough fluid to balance the renal solute load, which can vary widely inside the euhydration range. The subtle but important distinction between the 2 types of adequacy may explain some of the ambiguity surrounding the efficacy of hydration status markers. Both perspectives of fluid intake adequacy are discussed in detail and a simple tool is reviewed that may help healthy, active, low-risk populations answer the question, "Am I drinking enough?" Key Teaching Points • Adequate fluid intake can be dually defined as a volume of fluid (from water, beverages, and food) sufficient to replace water losses and provide for solute excretion. • Fluid needs can differ greatly among individuals due to variation in the factors that influence both water loss and solute balance; thus, adequacy is consistent with a wide range of fluid intakes and is better gauged using hydration assessment methods. • Adequacy of fluid intake for replacing meaningful water losses (dehydration) can be assessed simply, inexpensively, and with reasonable fidelity among healthy, active, low-risk individuals. • Adequacy of fluid intake for solute excretion per se can also be assessed among individuals but is more difficult to define and less practical to measure.
TL;DR: A systematic review of the current literature on fluid imbalance and management in PARDS, with special emphasis on potential differences with adult patients, to provide an incentive to develop age-specific fluid management protocols to improve PARDS outcomes.
Abstract: The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric acute respiratory distress syndrome (PARDS). Patients with ARDS have widespread damage of the alveolar-capillary barrier, potentially making them vulnerable to fluid overload with the development of pulmonary edema leading to prolonged course of disease. Indeed, studies in adults with ARDS have shown that an increased cumulative fluid balance is associated with adverse outcome. However, age-related differences in the development and consequences of fluid overload in ARDS may exist due to disparities in immunologic response and body water distribution. This systematic review summarizes the current literature on fluid imbalance and management in PARDS, with special emphasis on potential differences with adult patients. It discusses the adverse effects associated with fluid overload and the corresponding possible pathophysiological mechanisms of its development. Our intent is to provide an incentive to develop age-specific fluid management protocols to improve PARDS outcomes.
TL;DR: In patients with T2DM, ipragliflozin improved glycemic control after 1 month of treatment and caused weight loss by reducing body fat more than body water.
Abstract: Background: Ipragliflozin is a sodium-glucose co-transporter 2 inhibitor that can improve glycemic control and reduce body weight and blood pressure in patients with type 2 diabetes mellitus (T2DM). We evaluated the efficacy and safety of ipragliflozin in the real-world clinical setting, with a focus on the changes of body composition up to 3 months of treatment. Methods: This was a prospective multicenter interventional trial. We investigated changes of the blood pressure, body composition, blood glucose, hemoglobin A1c (HbA1c), ketone bodies, lipids, and insulin after treatment with ipragliflozin (50 - 100 mg/day) for 12 weeks in Japanese patients with T2DM who showed poor glycemic control despite receiving diet and exercise therapy with or without oral antidiabetic drugs for more than 12 weeks. Results: Two hundred and fifty-seven subjects were included in the efficacy analysis up to 12 weeks of treatment and 301 subjects were included in the safety analysis. From baseline to 12 weeks, HbA1c showed a change of -0.68% (95% confidence interval (CI): -0.83, -0.53) and fasting blood glucose showed a change of -23.9 mg/dL (95% CI: -30.5, -17.2), with both parameters displaying a significant reduction (P < 0.001). The difference of body weight from baseline was -1.82 kg (95% CI: -2.14, -1.50), and it also showed significant reduction (P < 0.001). Analysis of body composition revealed that body fat changed by -1.46 kg (95% CI: -1.79, -1.14, P < 0.001) and body water changed by -0.37 kg (95% CI: -0.60, -0.14, P < 0.01). Laboratory tests demonstrated improvement of liver function and the lipid profile. Adverse events (AEs) occurred in 22.6% of the subjects, with frequent events being vulvovaginal candidiasis in 2.7% and cystitis in 2.0%. Serious AEs occurred in three subjects. Conclusions: In patients with T2DM, ipragliflozin improved glycemic control after 1 month of treatment and caused weight loss by reducing body fat more than body water. J Clin Med Res. 2016;8(2):116-125 doi: http://dx.doi.org/10.14740/jocmr2417w Correction in J Clin Med Res. 2016;8(3):267-267, doi: http://dx.doi.org/10.14740/jocmr2417wc1
TL;DR: The results indicate that ∼30–40% of O in PO4 comprising DNA/biomass in early stationary phase cells is derived from metabolic water, which bolsters previous results and also suggests a constant metabolic water value for cells grown under similar conditions.
Abstract: Knowledge of the relative contributions of different water sources to intracellular fluids and body water is important for many fields of study, ranging from animal physiology to paleoclimate. The intracellular fluid environment of cells is challenging to study due to the difficulties of accessing and sampling the contents of intact cells. Previous studies of multicelled organisms, mostly mammals, have estimated body water composition—including metabolic water produced as a byproduct of metabolism—based on indirect measurements of fluids averaged over the whole organism (e.g., blood) combined with modeling calculations. In microbial cells and aquatic organisms, metabolic water is not generally considered to be a significant component of intracellular water, due to the assumed unimpeded diffusion of water across cell membranes. Here we show that the 18O/16O ratio of PO4 in intracellular biomolecules (e.g., DNA) directly reflects the O isotopic composition of intracellular water and thus may serve as a probe allowing direct sampling of the intracellular environment. We present two independent lines of evidence showing a significant contribution of metabolic water to the intracellular water of three environmentally diverse strains of bacteria. Our results indicate that ∼30–40% of O in PO4 comprising DNA/biomass in early stationary phase cells is derived from metabolic water, which bolsters previous results and also further suggests a constant metabolic water value for cells grown under similar conditions. These results suggest that previous studies assuming identical isotopic compositions for intracellular/extracellular water may need to be reconsidered.
TL;DR: It is suggested that regardless of sex, progressive RT induces an increase in phase angle and a rise in cellular hydration, and bioimpedance resistance decreased similarly in both sex.
Abstract: The main purpose of the present study was to investigate the effect of a hypertrophy-type resistance training protocol on phase angle, an indicator of cellular integrity, in young adult men and women 28 men (222±43 years, 678±90 kg and 1742±68 cm) and 31 women (232±41 years, 587±121 kg and 1627±64 cm) underwent a progressive RT for 16 weeks (2 phases, 8 weeks each), 3 times per week, consisting of 10 to 12 whole body exercises with 3 sets of 8–12 repetitions maximum Phase angle, resistance, reactance and total body water (intra and extracellular water compartments) were assessed by bioimpedance spectroscopy (Xitron 4200 Bioimpedance Spectrum Analyzer) Total body water, intracellular water and phase angle increased significantly (P 005) Bioimpedance resistance decreased (P
TL;DR: Body fluid composition changes differently during the course of uncomplicated pregnancies versus hypertensive pregnancies by using a bio-impedance analysis technique, which showed that total body water, intracellular (ICW) and extracellular water (ECW), and ECW/ICW significantly increase during the Course of pregnancy.
TL;DR: The main goal is to optimize drug therapy in children through a fundamental understanding of how ontogeny influences pharmacokinetics, which can be achieved through afundamental understanding of the role of organs important in metabolism and excretion.
Abstract: Human growth and development consist of a continuum of biological events. The impact of these developmental changes in drug disposition is largely related to changes in the body composition (e.g. body water content, plasma protein concentrations) and in the function of organs important in metabolism (e.g. the liver) and excretion (e.g. the kidney). The gastric emptying time during the neonatal period is prolonged, as well as intestinal motility. The ratio of body surface area to body weight is higher in children than in adults, which results in higher absorption of locally applied corticosteroids. Lower plasma protein levels and a higher body water content compared to adults may lead to diminished drug distribution. Phase I drug metabolizing system develops quickly and reaches adult levels between the third and sixth year of age. In newborns up to 3 months, the sulphotransferase activity is more developed than glucuronidation. Glomerular filtration, normalized to body surface area, approaches adult levels by 6 months of age. During the first decade of life, these changes are dynamic and can be non-linear and discordant, making standardized dosing inadequate. During rapid phases of growth/development, drug disposition and response may be altered. The main goal is to optimize drug therapy in children. This can be achieved through a fundamental understanding of how ontogeny influences pharmacokinetics.
TL;DR: The phase angle (PhA) as mentioned in this paper is a ratio of whole body reactance and resistance obtained from Bioelectrical Impedance Analysis (BIA), it indicates cellular health and integrity and is considered as prognostic tool in medical disorders.
Abstract: Introduction
Phase Angle (PhA) is a ratio of whole body reactance and resistance obtained from Bioelectrical Impedance Analysis (BIA). It indicates cellular health and integrity and is considered as prognostic tool in medical disorders. In spite of prognostic potentials of PhA, it has limited usefulness in clinical practice and in population studies because of non-availability of normal population reference limits for comparison. Moreover, it is influenced by various factors like age, sex, race and body composition (i.e. body fat, muscle mass, visceral fat, body cell mass, total body water, etc).
TL;DR: Participation in Ultraman Florida leads to fluid retention and dramatic alterations in body composition, muscle health, hormones, and metabolism.
Abstract: The primary purpose of this investigation was to determine the effects of participation in a 3-day multistage ultraendurance triathlon (stage 1 = 10 km swim, 144.8 km bike; stage 2 = 275.4 km bike; stage 3 = 84.4 km run) on body mass and composition, hydration status, hormones, muscle damage, and blood glucose. Eighteen triathletes (mean ± SD; age 41 ± 7.5 years; height 175 ± 9 cm; weight 73.5 ± 9.8 kg; male n = 14, female n = 4) were assessed before and after each stage of the race. Body mass and composition were measured via bioelectrical impedance, hydration status via urine specific gravity, hormones and muscle damage via venous blood draw, and blood glucose via fingerstick. Following the race, significant changes included reductions in body mass (qualified effect size: trivial), fat mass (moderate), and percent body fat (small); increases in percent total body water (moderate) and urine specific gravity (large); and unchanged absolute total body water and fat-free mass. There were also extremely large increases in creatine kinase, C-reactive protein, aldosterone and cortisol combined with reductions in testosterone (small) and the testosterone:cortisol ratio (moderate). There were associations between post-race aldosterone and total body water (r = −0.504) and changes in cortisol and fat-free mass (r = −0.536). Finally, blood glucose increased in a stepwise manner prior to each stage. Participation in Ultraman Florida leads to fluid retention and dramatic alterations in body composition, muscle health, hormones, and metabolism.
TL;DR: An eight-week administration of tofogliflozin improved glycemic control and reduced the body weight and free fat mass in type 2 diabetic patients without affecting the fat mass.
Abstract: Objective The adverse effects of selective sodium-glucose co-transporter 2 (SGLT2) inhibitors generally appear within about two or three months after treatment initiation in Japan. Therefore, we investigated the impact of tofogliflozin, a class of SGLT2 inhibitors, on glycemic control and body composition during this period in Japanese patients with type 2 diabetes mellitus. Methods This single-arm open-label study enrolled 20 patients. Patients received tofogliflozin 20 mg once daily for 8 weeks. At week 8, changes from baseline in body weight, serum metabolic markers, and body composition were evaluated. Results A total of 17 patients completed the 8-week administration of tofogliflodin. No serious adverse events were noted. Hemoglobin A1c (HbA1c) decreased significantly, from 7.8% to 7.3% with 8-week administration of tofogliflozin. Both the body weight and body mass index (BMI) also decreased. In addition, a decreased renal function of the boundary zone and hemoconcentration were detected. As for body composition, the free fat mass, total body water, extracellular water and intracellular water were all decreased significantly. Interestingly, the amount of fat mass did not change. The degree of improvement in HbA1c was correlated with the baseline fat mass and BMI. Conclusion An eight-week administration of tofogliflozin improved glycemic control and reduced the body weight and free fat mass in type 2 diabetic patients without affecting the fat mass. In this period, the hematocrit level and renal function should be monitored to guard against hemoconcentration and renal impairment, respectively.
Journal Article•
TL;DR: Ramadan fasting had beneficial effects on body composition, but did not have any significant effect on arterial stiffness and resting heart rate.
Abstract: OBJECTIVE To examine the effects of Ramadan fasting on body composition, arterial stiffness and resting heart rate. METHODS This prospective study was conducted at the Department of Cardiology, Harran University, Sanliurfa, Turkey, during Ramadan 2015, and comprised overweight and obese males. Body composition, arterial stiffness and echocardiography were assessed before and after Ramadan. Body composition was assessed by bioelectrical impedance analysis using segmental body composition analyser. Arterial stiffness and haemodynamic parameters were also measured. SPSS 20 was used for data analysis. RESULTS Of the 100 subjects enrolled, 70(70%) were included. The overall mean age was 37±7 years. No significant changes were observed in blood pressures, resting heart rate, aortic pulse wave velocity, aortic augmentation index-75, aortic pulse pressure, brachial pulse pressure, basal metabolic rate, total body water, fat-free mass, and echocardiographic parameters (p>0.05 each). Although aortic pulse wave velocity (m/s) and augmentation index-75 (%) decreased after fasting period compared to that of before Ramadan, these reductions did not reach statistically significant levels (8.6±1.8 vs. 8.9±1.9, and 13.6±6.6 vs. 14.7±9.3, respectively; p>0.05 each). Body mass index, waist-hip ratio, body water rate, percentage of body fat mass, body fat mass, and visceral fat mass percentage were significantly reduced (p<0.05 each) after Ramadan. CONCLUSIONS Ramadan fasting had beneficial effects on body composition, but did not have any significant effect on arterial stiffness and resting heart rate.
TL;DR: The U800 method could be employed to empirically determine 24-h TFI and 24-H urine volumes that correspond to inadequate water intake in diverse demographic groups, residents of specific geographic regions, and individuals who consume specialized diets or experience large daily water turnover.
Journal Article•
TL;DR: It is proposed that ECW/TBW may be used as the first, simple, and fast indicator of water volume status in the context of nutritional status and water balance in older subjects and to increase senior independence, resulting in longer self-maintenance at home and reduced hospital admissions.
Abstract: The aim of this study was to identify the best prognostic parameters for quickly assessing fluid volume status in the context of nutritional status and water balance in older persons and to facilitate decision-making of the general practitioner (GP). This pilot study was conducted with 142 volunteers aged 60 years or older who were Polish students of the University of the Third Age. Inclusion and exclusion criteria for the study were defined. Assessment tools included: the Mini Nutritional Assessment questionnaire (MNA®) and the anthropometric measurements. Weight and body composition analysis were determined by Bioelectrical Impedance Analysis (BIA) using the Tanita MC-780 multi frequency segmental Body Composition Analyzer. According to the MNA scale, 89.2% of the sample was wellnourished and 10.8% were at risk of malnutrition. A total of 47.1% participants had normal body mass index, 20.6% were overweight, and 32.3% were obese. The BIA showed that females had more fat mass (FM) compared to males (35.84% vs 23.90%), while men had more free fat mass (FFM) and total body water (TBW; 61.16% vs 45.22% and 53.31% vs 45.22%respectively). There were no statistically significant differences in FM, FFM, and TBW by age. The ratio of Extracellular to Total Body Water (ECW/TBW) was higher in women than in men (46.76% vs 43.66%). Of all measures, only ECW/TBW increased significantly with age and sex, especially after 65 years. We propose that ECW/TBW may be used as the first, simple, and fast indicator of water volume status in the context of nutritional status and water balance in older subjects. Systematic control of the ECW/TBW by GP or nurse may increase senior independence, resulting in longer self-maintenance at home and reduced hospital admissions.
TL;DR: The higher accuracy of BIS in predicting individual TBW, ECW, and ICW highlights its utility in water assessment of recreational and elite athletes.
Abstract: Objective: It is important for highly active individuals to easily and accurately assess their hydration level. Bioelectrical impedance (BIA) can potentially meet these needs but its validity in active individuals is not well established. We aim to validate total body water (TBW), extracellular water (ECW), and intracellular water (ICW) estimates obtained from 50 kHz BIA, bioelectrical impedance spectroscopy (BIS), and BIA-based models against dilution techniques in 2 populations: active adults and elite athletes.Methods: Active males (N = 28, 20–39 years) involved in recreational sports and elite athletes (females: N = 57, 16–35 years; males: N = 127, 16–38 years) participated in this study. TBW and ECW were assessed with deuterium and bromide dilution, respectively. ICW was assessed as their difference. Body water compartments were also assessed by BIA (BIA-101), BIS (model 4200), and BIA-based equations.Results: Small but significant differences were observed between alternative methods and the criteri...
TL;DR: This study demonstrated a strong relationship between fluid overload and PAH in HD patients, and demonstrated fluid overload to be an independent predictor of PAH after hemodialysis session.
Abstract: BACKGROUND Pulmonary arterial hypertension (PAH) is common disease among hemodialysis (HD) patients and is associated with increased morbidity and mortality. However, its pathogenesis has not been completely elucidated. We aimed to evaluate the frequency of PAH in HD patients, as well as the relationship between fluid status and PAH. MATERIAL AND METHODS We enrolled 77 HD patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status. BIA was performed before and 30 min after the midweek of HD. Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Echocardiographic examinations were performed before and after the HD. Pulmonary arterial hypertension was defined as systolic pulmonary artery pressure at rest (sPAP) higher than 35 mmHg. RESULTS PAH was found in 33.7% of the HD patients. OH/ECW and the frequency of fluid overload were significantly higher in HD patients with PAH than those without PAH, whereas serum albumin and hemoglobin levels were significantly lower. sPAP level was significantly higher in HD patients with fluid overload than in those without fluid overload after hemodialysis session. Furthermore, sPAP, OH/ECW levels, and the frequency of PAH were significantly reduced after HD. We also found a significant positive correlation between sPAP and OH/ECW. Multivariate logistic regression analysis demonstrated fluid overload to be an independent predictor of PAH after HD. CONCLUSIONS PAH is prevalent among HD patients. This study demonstrated a strong relationship between fluid overload and PAH in HD patients.
TL;DR: Adjusting SCr for acute change in fluid weight may help differentiate SCr rise from true change in renal function from acute concentration due to abrupt weight change.
Abstract: During the first postnatal weeks, infants have abrupt changes in fluid weight that alter serum creatinine (SCr) concentration, and possibly, the evaluation for acute kidney injury (AKI). We performed a prospective study on 122 premature infants to determine how fluid adjustment (FA) to SCr alters the incidence of AKI, demographics, outcomes, and performance of candidate urine biomarkers. FA-SCr values were estimated using changes in total body water (TBW) from birth; FA-SCR = SCr × [TBW + (current wt. – BW)]/ TBW; where TBW = 0.8 × wt in kg). SCr-AKI and FA-SCr AKI were defined if values increased by ≥ 0.3 mg/dl from previous lowest value. AKI incidence was lower using the FA-SCr vs. SCr definition [(23/122 (18.8 %) vs. (34/122 (27.9 %); p < 0.05)], with concordance in 105/122 (86 %) and discordance in 17/122 (14 %). Discordant subjects tended to have similar demographics and outcomes to those who were negative by both definitions. Candidate urine AKI biomarkers performed better under the FA-SCr than SCr definition, especially on day 4 and days 12–14. Adjusting SCr for acute change in fluid weight may help differentiate SCr rise from true change in renal function from acute concentration due to abrupt weight change.
TL;DR: The shortening of the BIVA vector indicates that fluid gain occurred during the Giro d’Italia, and power output and RPE, mostly depending on team tactic, were not affected by the body water increases.
Abstract: The aim of the study was to investigate changes in hydration status by means of bioelectrical impedance vector analyses (BIVA) and to assess its influence on power output and rating of perceived exertion (RPE) during the Giro d'Italia 2014. Daily bioelectrical impedance analysis were performed on 9 professional road cyclists (age: 28.2 ± 4.7 yr, height: 176.0 ± 5.5 cm, weight: 64.7 ± 3.4 kg) during the race. Additionally, body weight, RPE, and power output were recorded throughout the race. Impedance vectors shortened during the race, whereas body weight remained unchanged at the end of the tour when compared to pre-tour. Vector changes were not related to power output or RPE. The shortening of the BIVA vector indicates that fluid gain occurred during the Giro d'Italia. This fluid gain was not reflected by body weight measurements and might be mainly attributed to muscle edema and/or haemodilution. Furthermore, power output and RPE, mostly depending on team tactic, were not affected by the body water increases.
TL;DR: Non-invasive determination of body-water composition using bioimpedance spectroscopy is feasible in critically ill patients but requires knowledge of the patient’s weight, and the best method to assess volume status after fluid resuscitation and the value gained from information about body composition provided by bioIMpedance techniques needs further evaluation.
Abstract: Fluid management is a crucial issue in intensive-care medicine. This study evaluated the feasibility and reproducibility of bioimpedance spectroscopy to measure body-water composition in critically ill patients, and compared fluid balance and daily changes in total body water (TBW) measured by bioimpedance. This observational study included 25 patients under mechanical ventilation. Fluid balance and bioimpedance measurements were recorded on 3 consecutive days. Whole-body bioimpedance spectroscopy was performed with exact or ideal body weights entered into the device, and with or without ICU monitoring. Reproducibility of bioimpedance spectroscopy was very good in all conditions despite ICU monitoring and mechanical ventilation. Bioimpedance measurements using an ideal body weight varied significantly, making the weighing procedure necessary. Comparison of fluid balance and daily changes in body weight provided the best correlation (ρ = 0.74; P 10 (ρ = 0.36; P = 0.05) and with extracorporeal circulation (ρ = 0.50; P = 0.005). Regardless of the technique used to estimate volume status, important limits of agreement were observed. Non-invasive determination of body-water composition using bioimpedance spectroscopy is feasible in critically ill patients but requires knowledge of the patient’s weight. The best method to assess volume status after fluid resuscitation and the value gained from information about body composition provided by bioimpedance techniques needs further evaluation.
TL;DR: It is concluded that, whereas individual RXc-score graph values do not provide accurate detection of dehydration from single measurements, directional changes in vector values from serial measurements are consistent with fluid loss for both ED and ID conditions.
TL;DR: The results indicate that the Pea Pod system is accurate for groups of newborn, moderately premature infants, and more studies where this system is used for premature infants are needed, and suggestions regarding how to develop this area are provided.
Abstract: (1) Background: Assessing the quality of growth in premature infants is important in order to be able to provide them with optimal nutrition. The Pea Pod device, based on air displacement plethysmography, is able to assess body composition of infants. However, this method has not been sufficiently evaluated in premature infants; (2) Methods: In 14 infants in an age range of 3–7 days, born after 32–35 completed weeks of gestation, body weight, body volume, fat-free mass density (predicted by the Pea Pod software), and total body water (isotope dilution) were assessed. Reference estimates of fat-free mass density and body composition were obtained using a three-component model; (3) Results: Fat-free mass density values, predicted using Pea Pod, were biased but not significantly (p > 0.05) different from reference estimates. Body fat (%), assessed using Pea Pod, was not significantly different from reference estimates. The biological variability of fat-free mass density was 0.55% of the average value (1.0627 g/mL); (4) Conclusion: The results indicate that the Pea Pod system is accurate for groups of newborn, moderately premature infants. However, more studies where this system is used for premature infants are needed, and we provide suggestions regarding how to develop this area.