ABSTRACT BACKGROUND Bioelectrical impedance analysis (BIA) is a validated method to assess body composition in persons with fluid homeostasis and reliable body weight. This is not the case

during critical illness. The raw BIA markers resistance, reactance, phase angle, and vector length are body weight independent. Phase angle reflects cellular health and has prognostic

significance. We aimed to assess the course of phase angle and vector length during intensive care unit (ICU) admission, and determine the relation between their changes (Δ) and changes in

body hydration. METHODS A prospective, dual-center observational study of adult ICU patients was conducted. Univariate and multivariable regression analyses were performed, including

Ω), phase angle (−0.4 ± 1.1°), and vector length (−12.2 ± 44.3 Ω/m). Markers of hydration significantly increased. Δphase angle and Δvector length were both positively related to

Δreactance/_m_ (_r_2 = 0.55, _p_ < 0.01; _r_2 = 0.38, _p_ < 0.01). Adding ΔTBWBiasioli as explaining factor strongly improved the association between Δphase angle and Δreactance/m

(_r_2 = 0.73, _p_ < 0.01), and Δvector length and Δreactance/_m_ (_r_2 = 0.77, _p_ < 0.01). CONCLUSIONS Our results show that during critical illness, changes in phase angle and vector

length partially reflect changes in hydration. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access

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subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS USEFULNESS OF BIOELECTRICAL IMPEDANCE ANALYSIS AND ECW RATIO AS A GUIDANCE FOR FLUID

MANAGEMENT IN CRITICALLY ILL PATIENTS AFTER OPERATION Article Open access 09 June 2021 PREDICTION OF FLUID RESPONSIVENESS IN SPONTANEOUSLY BREATHING PATIENTS WITH HEMODYNAMIC STABILITY: A

PROSPECTIVE REPEATED-MEASURES STUDY Article Open access 24 June 2024 DO WE NEED DIFFERENT PREDICTIVE EQUATIONS FOR THE ACUTE AND LATE PHASES OF CRITICAL ILLNESS? A PROSPECTIVE OBSERVATIONAL

STUDY WITH REPEATED INDIRECT CALORIMETRY MEASUREMENTS Article 30 August 2021 DATA AVAILABILITY The datasets used and/or analyzed during the current study are available from the corresponding

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We would like to acknowledge the ICU research nurses for their invaluable help with the BIA measurements. FUNDING The present study was supported by departmental funding. AUTHOR INFORMATION

AUTHORS AND AFFILIATIONS * Department of Adult Intensive Care Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands Nadine Denneman, Bo Broens, Jolijn Gjaltema, 

Sandra N. Stapel, Julius Stohlmann & Heleen M. Oudemans-van Straaten * Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The

Netherlands Lara Hessels & Maarten W. Nijsten Authors * Nadine Denneman View author publications You can also search for this author inPubMed Google Scholar * Lara Hessels View author

publications You can also search for this author inPubMed Google Scholar * Bo Broens View author publications You can also search for this author inPubMed Google Scholar * Jolijn Gjaltema

View author publications You can also search for this author inPubMed Google Scholar * Sandra N. Stapel View author publications You can also search for this author inPubMed Google Scholar *

Julius Stohlmann View author publications You can also search for this author inPubMed Google Scholar * Maarten W. Nijsten View author publications You can also search for this author

inPubMed Google Scholar * Heleen M. Oudemans-van Straaten View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS ND is the main writer of the

paper, collected the data for the Department of Adult Intensive Care Medicine, Amsterdam UMC, VU University Medical Center, analyzed, and interpreted the patient data. LH collected the data

for the Department of Critical Care, University of Groningen, University Medical Centre Groningen, assisted with data analysis, and contributed to writing the paper. BB and JS contributed to

collecting data for the Department of Adult Intensive Care Medicine, Amsterdam UMC, VU University Medical Center and to writing the paper. JG, SNS, and MWN contributed to writing the paper.

HMOS participated in the design, the statistical analysis, interpretation of the data, and in the drafting and writing of the paper. All authors read and approved the final paper.

CORRESPONDING AUTHOR Correspondence to Nadine Denneman. ETHICS DECLARATIONS CONFLICT OF INTEREST The bioelectrical impedance device was financed by an unrestricted research grant from

Nutricia Medical Care. ETHICAL APPROVAL The study protocol was approved by the local research ethics committee (VU University Medical Center, amendment to METc reference number 2013.318, UMC

Groningen, METc 2016.691). Since all patient data were anonymized and BIA is noninvasive with a low patient burden the need for informed consent was waived. ADDITIONAL INFORMATION

PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. SUPPLEMENTARY INFORMATION SUPPLEMENT 1. THE RELATION

BETWEEN CHANGES IN PHASE ANGLE, VECTOR LENGTH AND WEIGHT DEPENDENT MARKERS OF HYDRATION SUPPLEMENT 2. THE RELATION BETWEEN BODY WEIGHT DEPENDENT BCM AND MM AND MARKERS OF HYDRATION

SUPPLEMENT 3. THE RELATION BETWEEN BIA-DERIVED PARAMETERS AND SEVERITY OF DISEASE SCORES SUPPLEMENT 4. CONSORT DIAGRAM RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE

THIS ARTICLE Denneman, N., Hessels, L., Broens, B. _et al._ Fluid balance and phase angle as assessed by bioelectrical impedance analysis in critically ill patients: a multicenter

prospective cohort study. _Eur J Clin Nutr_ 74, 1410–1419 (2020). https://doi.org/10.1038/s41430-020-0622-7 Download citation * Received: 06 October 2019 * Revised: 20 March 2020 * Accepted:

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