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Knee-to-knee bioimpedance measurements to monitor changes in extracellular fluid in haemodynamic-unstable patients during dialysis

Abdul Hamid Ismail
Abdul Hamid Ismail
, 
Georg Schlieper
Georg Schlieper
, 
Marian Walter
Marian Walter
, 
Jürgen Floege
Jürgen Floege
 and 
Steffen Leonhardt
Steffen Leonhardt
   | Aug 20, 2019
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Published Online: Aug 20, 2019
Page range: 55 - 62
Received: Mar 25, 2019
DOI: https://doi.org/10.2478/joeb-2019-0008
Keywords
© 2019 Ismail, Schlieper, Walter, Floege, Leonhardt, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig.1

Position of the electrodes for (a) the whole-body BIS (whBIS) and (b) knee-to-knee BIS (kkBIS) measurements. Four electrodes were used for each of the BIS methods, i.e. two for current injection I(t) and two for voltage sensing V(t).
Position of the electrodes for (a) the whole-body BIS (whBIS) and (b) knee-to-knee BIS (kkBIS) measurements. Four electrodes were used for each of the BIS methods, i.e. two for current injection I(t) and two for voltage sensing V(t).

Fig.2

Relationship of relative changes in different BIS parameters estimated on basis of pre-HD and post-HD values from kkBIS and whBIS methods. The relative changes were calculated as (|pre-HD – post-HD|)/pre-HD x 100 for (a) ΔRe (%), (b) ΔRe/UFV (%/L), (c) ΔECF (%) and (d) ΔECF (%) according to [15, 16]. Each patient has two entries.
Relationship of relative changes in different BIS parameters estimated on basis of pre-HD and post-HD values from kkBIS and whBIS methods. The relative changes were calculated as (|pre-HD – post-HD|)/pre-HD x 100 for (a) ΔRe (%), (b) ΔRe/UFV (%/L), (c) ΔECF (%) and (d) ΔECF (%) according to [15, 16]. Each patient has two entries.

Fig.3

Graphs showing the trends (mean±SD) in the patient groups for (a) relative change in knee-to-knee extracellular resistance (ΔRe,kkBIS), (b) relative change in total body extracellular resistance (ΔRe,whBSI), both normalized by UFV (removed during the corresponding time interval), (c) the ratio of ΔRe,kkBIS to ΔRe,whBIS, and (d) the relative changes in extracellular fluid (ΔECF, %) measured by kkBIS and whBIS during the time course of the treatment.
Graphs showing the trends (mean±SD) in the patient groups for (a) relative change in knee-to-knee extracellular resistance (ΔRe,kkBIS), (b) relative change in total body extracellular resistance (ΔRe,whBSI), both normalized by UFV (removed during the corresponding time interval), (c) the ratio of ΔRe,kkBIS to ΔRe,whBIS, and (d) the relative changes in extracellular fluid (ΔECF, %) measured by kkBIS and whBIS during the time course of the treatment.

Fig.4

Pre-HD to post-HD comparison of (a-b) relative changes in Re,kkBIS (%) and Re,whBIS (%), respectively, with changes of patient weight (%). Pre-HD to post-HD comparison of (c-d) changes in ΔECFkkBIS (L) or ΔECFwhBIS (L), respectively, with cumulative ultrafiltration volume (UFV, L). Each patient has two entries.
Pre-HD to post-HD comparison of (a-b) relative changes in Re,kkBIS (%) and Re,whBIS (%), respectively, with changes of patient weight (%). Pre-HD to post-HD comparison of (c-d) changes in ΔECFkkBIS (L) or ΔECFwhBIS (L), respectively, with cumulative ultrafiltration volume (UFV, L). Each patient has two entries.

Fig.5

Data (mean ± SD) showing the accumulative changes in extracellular fluid (ECF) associated with accumulative ultrafiltration volume (UFV) as recorded by the dialysis machine during treatment at the time points 30, 60, 90, 120,150 and 180 min from the start of dialysis. SD lines were omitted from the graph to maintain visual clarity.
Data (mean ± SD) showing the accumulative changes in extracellular fluid (ECF) associated with accumulative ultrafiltration volume (UFV) as recorded by the dialysis machine during treatment at the time points 30, 60, 90, 120,150 and 180 min from the start of dialysis. SD lines were omitted from the graph to maintain visual clarity.

Pre-dialysis physical and clinical characteristics. Data are means ± SD from 20 patients (40 measurements).

Baseline CharacteristicsHemodialysispatients
Stable (n = 10)Unstable (n = 10)p
Gender, % female20.050.00.350
Age, years63.3 ± 15.860.7 ± 16.40.722
Height, cm174.7 ± 7.9165.8 ± 9.00.030
Weight, kg83.6 ± 8.369.5 ± 17.30.038
BMI, Kg / m227.5 ± 3.425.4 ± 6.80.398
Dialysis duration, min234.0 ± 19.0222.0 ± 29.00.290
Ultrafiltration Rate, ml / h557.5 ± 305.7564.2 ± 235.10.957
UFV, mL2252.0 ± 1226.92300.0 ± 1091.40.927
SysBP, mmHg123.7 ± 17.2125.4 ± 19.10.836
DiaBP, mmHf71.5 ± 14.664.1 ± 11.60.226
ECFwhBIS, L21.6 ± 2.417.3 ± 3.90.009
ECFkkBIS, L2.7 ± 0.52.6 ± 0.70.769
Body temperature, °C36.0 ± 0.635.9 ± 0.40.688
O2 saturation, %96.9 ± 2.496.6 ± 2.70.796
Plasma Na+, mmol / L136.8 ± 2.1136.7 ± 2.70.928
Plasma K+, mmol / L4.4 ± 0.74.7 ± 1.00.530
Plasma ionized Ca2+, mmol / L1.1 ± 0.11.1 ± 0.10.461
Plasma glucose, mmol / L121.4 ± 27.8124.6 ± 31.30.809
eISSN:
1891-5469
Language:
English
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Volume Open
Journal Subjects:
Engineering, Bioengineering and Biomedical Engineering, Biomedical Electronics, Life Sciences, Biophysics, Medicine, Biomedical Engineering, Physics, Spectroscopy and Metrology
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