Clinical applications, limitations and prognostic value of electrical bioimpedance analysis in critically ill patients: A narrative review
DOI:
https://doi.org/10.70983/b8pb7z19Keywords:
Bioelectrical impedance analysis, Body composition, Nutritional status, Critical illnessAbstract
Critically ill patients experience marked changes in body composition, making monitoring essential. This narrative review summarizes the literature on the clinical applications, limitations, and prognostic value of bioelectrical impedance analysis (BIA) in intensive care.
A systematic search of PubMed, the Cochrane Library, and Google Scholar was conducted using MeSH terms and keywords related to BIA, body composition, nutritional status, and critical illness. Scientific articles and book chapters relevant to the research subtopics were selected.
Due to fluid resuscitation, traditional BIA predictive equations overestimate fat-free mass. Current evidence supports using overhydration adjustment models and prioritazing direct cellular parameters, such as vector analysis and phase angle (PA). PA is a useful surrogate biomarker for detecting impaired cellular integrity and muscle loss. Longitudinal monitoring of PA has high prognostic value: a decreased PA predicts higher mortality, prolonged ventilation, and neuromuscular sequelae of post-ICU syndrome (ICU-acquired weakness and post-extubation dysphagia).
When interpreted with methodological rigor, BIA identifies overhydration, stratifies the risk of complications, and reliably assesses body fluid reserves. After discharge from the ICU, an objective assessment of long-term recovery is possible.
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