Introduction. We wished to determine bioelectrical impedance (BIA) correlates before hydration or changes during hydration and determine if these changes were prognostically important.
Methods and Materials. Fifty eligible patients underwent BIA measurements 3 consecutive days. Laboratory studies (electrolytes, creatinine, and hemoglobin) on day 1; weights and vital signs were recorded. Kaplan-Meier survival estimates were made at 30 and 60 days. Hazard ratios (HRs) based on Cox proportional hazards model were calculated.
Results. Weight loss was associated with shorter survival. A higher phase angle (PA) on day 1 predicted longer survival. Increased PA during hydration predicted shorter survival: increased weight during hydration predicted longer survival.
Discussion. Higher phase angle before hydration predicts poorer survival and, paradoxically, an increase in phase angle during hydration predicted poorer survival and preexisting intracellular dehydration, cachexia, or poor membrane function. Conclusions. Phase angle and weight during hydration predict survival in cancer.
Sarhill N., Walsh D., Nelson K., Davis M.Evaluation and treatment of cancer-related fluid deficits: Volume depletion and dehydration. Support Care Cancer. 2001 ;9:408-419.
2.
Mange K., Matsuura D., Cizman B.Language guiding therapy: the case of dehydration versus volume depletion . Ann Intern Med. 1997;127:848-853.
Haussinger D. , Roth E., Lang F., Gerok W.Cellular hydration state: an important determinant of protein catabolism in health and disease. Lancet. 1993;341:1330-1332.
5.
Barbosa-Silva M., Barros A.Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations. Curr Opin Clin Nutr Metab Care.2005;8:311-317.
6.
Haussinger D. , Lang F., Gerok W.Regulation of cell function by the cellular hydration state. Am J Physiol.1994;267(3 pt 1):E343-E355.
7.
Haussinger D. , Gerok W.Role of the cellular hydration state for cellular function: physiological and pathophysiological aspects. Adv Exp Med Biol. 1994;368:33-44.
8.
Finn P., Plank LD, Clark MA, Connolly AB, Hill GLProgressive cellular dehydration and proteolysis in critically ill patients . Lancet. 1996;347:654-656.
9.
Morita T., Tsunoda J., Inoue S., Chihara S.Improved accuracy of physicians' survival prediction for terminally ill cancer patients using the Palliative Prognostic Index. Palliat Med . 2001;15:419-424.
10.
Schwenk A., Beisenherz A., Römer K., Kremer G., Salzberger B., Elia M.Phase angle from bioelectrical impedance analysis remains an independent predictive marker in HIV-infected patients in the era of highly active antiretroviral treatment. Am J Clin Nutr. 2000;72:496-501.
11.
Kyle U., Bosaeus I., De Lorenzo AD, et al, and the Composition of the ESPEN Working Group.Bioelectrical impedance analysis-part I: review of principles and methods. Clin Nutr. 2004;23:1226-1243.
12.
Kyle U., Bosaeus I., De Lorenzo AD, et al. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004;23:1430-1453.
13.
Sergi G., Bussolotto M., Perini P., et al. Accuracy of bioelectrical impedance analysis in estimation of extracellular space in healthy subjects and in fluid retention states. Ann Nutr Metab. 1994;38:158-165.
14.
Simpson J., Lobo DN, Anderson JA, et al. Body water compartment measurements: a comparison of bioelectrical impedance analysis with tritium and sodium bromide dilution techniques. Clin Nutr. 2001;20:339-343.
15.
Segal K., Burastero S., Chun A., Coronel P., Pierson RN Jr, Wang J.Estimation of extracellular and total body water by multiple-frequency bioelectrical-impedance measurement. Am J Clin Nutr. 1991;54:26-29.
16.
Lukaski H.A new approach to estimate changes in total body water by bioelectrical impedance analysis. Nutrition. 1997;13:474-475.
17.
Piccoli A.Whole body-single frequency bioimpedance. Contrib Nephrol . 2005;149:150-161.
18.
Scheltinga M., Jacobs DO, Kimbrough TD, Wilmore DWAlterations in body fluid content can be detected by bioelectrical impedance analysis. J Surg Res. 1991;50:461-468.
19.
Toso S., Piccoli A., Gusella M., et al. Altered tissue electric properties in lung cancer patients as detected by bioelectric impedance vector analysis. Nutrition . 2000;16:120-124.
20.
Lukaski H.Biological indexes considered in the derivation of the bioelectrical impedance analysis. Am J Clin Nutr.1996;64(3 suppl):397S-404S.
21.
Piccoli A.Whole body-single frequency bioimpedance. Contrib Nephrol . 2005;149:150-161.
22.
Bosy-Westphal A., Danielzik S., Ralf-Peter D., et al. Phase angle from bioelectrical impedance analysis: population reference values by age, sex, and body mass index. JPEN J Parenter Enteral Nutr. 2006;30:309-316.
23.
Ritz P.Body water spaces and cellular hydration during healthy aging. Ann N Y Acad Sci. 2000;904:474-483.
24.
Buffa R., Floris G., Marini E.Migration of the bioelectrical impedance vector in healthy elderly subjects . Nutrition. 2003;19:917-921.
25.
Toso S., Piccoli A., Gusella M., et al. Bioimpedance vector pattern in cancer patients without disease versus locally advanced or disseminated disease. Nutrition . 2003;19:510-514.
26.
Barbosa-Sila M., Barros A., Wang J., Heymsfield S., Pierson R. Jr.Bioelectrical impedance analysis: population reference values for phase angle by age and sex. Am J Clin Nutr.2005;82:49-52.
27.
Schoeller D.Bioelectrical impedance analysis. What does it measure? Ann N Y Acad Sci. 2000;904:159-162.
28.
Simons J., Schols A., Westerterp K., ten Velde GP, Wouters EFThe use of bioelectrical impedance analysis to predict total body water in patients with cancer cachexia. Am J Clin Nutr. 1995;61:741-745.
29.
Chumlea W., Guo S., Kuczmarski R., et al. Body composition estimates from NHANES III bioelectrical impedance data. International J of Obesity. 2002;26:1596-1609.
30.
Morita T., Hyodo I., Yoshimi T., et al, for the Japan Palliative Oncology Study Group.Artificial hydration therapy, laboratory findings, and fluid balance in terminally ill patients with abdominal malignancies. J Pain Symptom Manage.2006;31:130-139.
31.
Morita T., Hyodo I., Yoshimi T., et al, and the Japan Palliative Oncology Study Group.Association between hydration volume and symptoms in terminally ill cancer patients with abdominal malignancies. Ann Oncol.2005;16:640-647.
32.
Glare P., Eychmueller S., McMahon P.Diagnostic accuracy of the palliative prognostic score in hospitalized patients with advanced cancer. J Clin Oncol. 2004;22:4823-4828.
33.
Stone P., Lund S.Predicting prognosis in patients with advanced cancer. Ann Oncol. 2007;18:971-976.
34.
Wirth R., Bauer J., Sieber C.Cognitive function, body weight and body composition in geriatric patients . Z Gerentol Geriatr. 200;40:13-20.
35.
De Luis D., Izaola O., Cuellar L., et al. Nutritional assessment: predictive variables at hospital admission related with length of stay. Ann Nutr Metab. 2006;50:394-398.
36.
Maltoni M., Amadori D.Prognosis in advanced cancer. Hematol Oncol Clin North Am . 2002;16:715-729.
