scholarly journals Passive longitudinal weight and cardiopulmonary monitoring in the home bed

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicholas Harrington ◽  
Quan M. Bui ◽  
Zhe Wei ◽  
Brandon Hernandez-Pacheco ◽  
Pamela N. DeYoung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Weight ◽  
Artery Bypass ◽  
Home Monitoring ◽  
Total Body Weight ◽  
Sleep Studies ◽  
Cardiopulmonary Monitoring ◽  
Home Health Monitoring ◽  
Total Body ◽  
Central Apneas

AbstractHome health monitoring has the potential to improve outpatient management of chronic cardiopulmonary diseases such as heart failure. However, it is often limited by the need for adherence to self-measurement, charging and self-application of wearables, or usage of apps. Here, we describe a non-contact, adherence-independent sensor, that when placed beneath the legs of a patient’s home bed, longitudinally monitors total body weight, detailed respiratory signals, and ballistocardiograms for months, without requiring any active patient participation. Accompanying algorithms separate weight and respiratory signals when the bed is shared by a partner or a pet. Validation studies demonstrate quantitative equivalence to commercial sensors during overnight sleep studies. The feasibility of detecting obstructive and central apneas, cardiopulmonary coupling, and the hemodynamic consequences of non-sustained ventricular tachycardia is also established. Real-world durability is demonstrated by 3 months of in-home monitoring in an example patient with heart failure and ischemic cardiomyopathy as he recovers from coronary artery bypass grafting surgery. BedScales is the first sensor to measure adherence-independent total body weight as well as longitudinal cardiopulmonary physiology. As such, it has the potential to create a multidimensional picture of chronic disease, learn signatures of impending hospitalization, and enable optimization of care in the home.

P5407Body-composition analysis of patients with acute heart failure - preliminary results from the SCALE HF trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F De Ieso ◽  
M Mutke ◽  
J Du Fay De Lavallaz ◽  
C Raichle ◽  
N Brasier ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Composition ◽  
Body Weight ◽  
Diuretic Therapy ◽  
Total Body Weight ◽  
Body Water ◽  
Extracellular Water ◽  
Raw Data ◽  
Weight Measurement ◽  
Total Body

Abstract Background Guidance for intensified diuretic therapy in acute heart failure (AHF) is mainly based on body weight measurement, frequently leading to a short episode of dehydration with kidney failure after recompensation. In addition, patients often present immobilized due to severe health issues making weight measurement stressful. Purpose Bioelectrical impedance analysis (BIA) may be a more direct approach to guide intensified diuretic therapy analysing patient's body composition. We hypothesized that patient's weight loss during therapy correlates with loss of body water measured by BIA. Therefore, we tested if this method could be an alternative to daily weight measurement. Methods We conducted an observational, single-centre study to evaluate and monitor body composition of patients hospitalised with AHF, adjudicated according to current ESC/HFA guidelines by a cardiologist. We used an eight-electrode, segmental, multi-frequency body composition analyser, previously validated against air displacement plethysmography, whole body MRI, deuterium and sodium bromide dilution. We investigated patients until hospital discharge or latest one day after ending intensified diuretic therapy. Disease specific properties, BIA and weight measurement were assessed daily. Furthermore, we investigated BIA raw data. Results 390 BIA were applied on 76 patients (47 men; 29 women; mean age 76±11 years; mean weight 75.6±15.7 kg). 34 patients presented with global, 27 with left-heart, 8 with right-heart and 7 with not specified AHF. 44 patients presented with pleural effusion. Pearson correlations showed that total body water (r=0.737, p≤0.001) and extracellular water (r=0.69, p≤0.001) correlated each with total body weight. Changes in total body water accurately (within a range of ± 1kg) reflected changes in total body weight in 40.28% of the patients and changes in extracellular water showed a similarly accurate reflection of total body weight change in 68.06% of the patients. BIA raw-data analysis showed significant changes using Wilcoxon test between measurements at the beginning of intensified diuretic therapy and at its end. We found a significant increase of resistance (mean from 334.6±67.5 to 362.8±69.5 Ohm/m; p=0.021) and reactance (mean from 21.3±7.1 to 24.1±6.2 Ohm/m; p=0.009) standardized to patients height and a non-significant increase of phase angle (mean from 3.6±0.9 to 3.8±0.8 °; p=0.149) during hospitalisation. Conclusion BIA is able to estimate changes in total body weight by analysing changes in extracellular body water in patients under intensified diuretic therapy and raw data analysis seems even more accurate and promising. This data derive from a heterogeneous AHF patient group, needing further investigation. Once validated, wearable BIA connected to an automated device monitoring system would enable an easy to use diuretic therapy monitoring for impaired patients or outpatients and could help reducing care efforts.

Theophylline Clearance in Obese Patients in Relation to Smoking and Congestive Heart Failure

1983 ◽  
Vol 17 (4) ◽  
pp. 274-276 ◽  
Author(s):  
Richard L. Slaughter ◽  
Robert A. Lanc
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Body Weight ◽  
Ideal Body Weight ◽  
Total Body Weight ◽  
Obese Patients ◽  
Ideal Body ◽  
Total Body ◽  
Nonobese Patients ◽  
Body Clearance

The effect of obesity on the total body clearance (Cltot) of theophylline was evaluated in nonsmokers and smokers with and without congestive heart failure (CHF). The obese patients were compared with similar nonobese subjects with regard to age, sex, and disease state. The total patient population numbered 150 adults. Cltot of theophylline, based on total body weight (TBW), averaged 0.60 ± 0.20 ml/min/kg in obese nonsmokers and did not differ from the nonobese, nonsmoking group. In obese nonsmoking patients with CHF, Cltot based on TBW was 0.40 ± 0.14 ml/min/kg, which was similar to Cltot values in nonsmoking CHF patients who were not obese. A trend toward a reduction in Cltot, based on TBW, as TBW increased, in nonsmoking patients with and without CHF, was observed. In contrast to the Cltot in nonsmokers, the Cltot of theophylline in obese smokers with and without CHF was similar to the Cltot values in nonobese populations only when based on ideal body weight. However, when compared with nonsmoking, nonobese patients, no differences were observed when Cltot was corrected for TBW. These findings suggest that theophylline maintenance dose can be based on TBW in obese patients who are smokers and nonsmokers (with and without CHF), using the average Cltot obtained for the nonsmoking patients with and without CHF.

scholarly journals Renal Replacement Therapy in Patients with Heart and Kidney Failure

PRILOZI ◽  
2016 ◽  
Vol 37 (2-3) ◽  
pp. 43-47
Author(s):  
Dimitrios S Goumenos ◽  
Evangelos Papachristou ◽  
Marios Papasotiriou
Keyword(s):  
Heart Failure ◽  
Weight Loss ◽  
Body Weight ◽  
Renal Replacement Therapy ◽  
Fluid Overload ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Decompensated Heart Failure ◽  
Total Body ◽  
Total Body Weight Loss

Abstract The incidence of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) is high as CKD and CHF share underlying risk factors such as arterial hypertension, diabetes mellitus and atherosclerosis. Cardiac failure leads to renal hypoperfusion and dysfunction and then fluid overload and need for aggressive diuretic therapy. However, development of diuretic resistance represents a significant problem in the management of these patients. The role of Renal Replacement Therapy (RRT) is important for patients who do not response to conservative management of fluid overload facilitating the failing heart to restore function. According to the guidelines, venovenous isolated Ultrafiltration (UF) is indicated for patients with refractory congestion not responding to medical therapy with loop diuretics and infusion of dopamine. A systematic review of randomized controlled trials on the effect of UF vs. IV furosemide for decompensated heart failure showed a benefit of UF on total body weight loss and on readmissions due to heart failure in patients with decompensated heart failure and CKD. Peritoneal dialysis (PD) can provide efficient ultrafiltration and sodium extraction in volume overloaded patients followed by decline of hospitalization days, decrease of body weight and improvement of LVEF in patients with refractory heart failure. The continuous draw of ultrafiltrate is followed by a lesser risk of abrupt hypotension and better preservation of the residual kidney function. This represents a significant advantage of PD over intermittent UF by dialysis. In conclusion, application of UF by dialysis and PD is followed by significant total body weight loss, reduced need for hospital readmissions and better quality of life. PD has a higher probability of preservation of residual kidney function and can be used by patients at home.

scholarly journals Lean body weight versus total body weight to calculate the iodinated contrast media volume in abdominal CT: a randomised controlled trial

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Moreno Zanardo ◽  
Fabio Martino Doniselli ◽  
Anastassia Esseridou ◽  
Massimiliano Agrò ◽  
Nicol Antonina Rita Panarisi ◽  
...  
Keyword(s):  
Body Weight ◽  
Contrast Media ◽  
Controlled Trial ◽  
Total Body Weight ◽  
Lean Body Weight ◽  
Iodinated Contrast Media ◽  
Abdominal Ct ◽  
Iodinated Contrast ◽  
Significant Difference ◽  
Total Body

Abstract Objectives Iodinated contrast media (ICM) could be more appropriately dosed on patient lean body weight (LBW) than on total body weight (TBW). Methods After Ethics Committee approval, trial registration NCT03384979, patients aged ≥ 18 years scheduled for multiphasic abdominal CT were randomised for ICM dose to LBW group (0.63 gI/kg of LBW) or TBW group (0.44 gI/kg of TBW). Abdominal 64-row CT was performed using 120 kVp, 100–200 mAs, rotation time 0.5 s, pitch 1, Iopamidol (370 mgI/mL), and flow rate 3 mL/s. Levene, Mann–Whitney U, and χ2 tests were used. The primary endpoint was liver contrast enhancement (LCE). Results Of 335 enrolled patients, 17 were screening failures; 44 dropped out after randomisation; 274 patients were analysed (133 LBW group, 141 TBW group). The median age of LBW group (66 years) was slightly lower than that of TBW group (70 years). Although the median ICM-injected volume was comparable between groups, its variability was larger in the former (interquartile range 27 mL versus 21 mL, p = 0.01). The same was for unenhanced liver density (IQR 10 versus 7 HU) (p = 0.02). Median LCE was 40 (35–46) HU in the LBW group and 40 (35–44) HU in the TBW group, without significant difference for median (p = 0.41) and variability (p = 0.23). Suboptimal LCE (< 40 HU) was found in 64/133 (48%) patients in the LBW group and 69/141 (49%) in the TBW group, but no examination needed repeating. Conclusions The calculation of the ICM volume to be administered for abdominal CT based on the LBW does not imply a more consistent LCE.

Increases in adipose and total body weight, but not in lean body mass, associated with subcutaneous administration of Sonic hedgehog-Ig fusion protein to mice

2002 ◽  
Vol 57 (3) ◽  
pp. 107-114 ◽  
Author(s):  
Pauline L. Martin ◽  
Joan Lane ◽  
Louise Pouliot ◽  
Malcolm Gains ◽  
Rudolph Stejskal ◽  
...  
Keyword(s):  
Body Weight ◽  
Fusion Protein ◽  
Lean Body Mass ◽  
Body Mass ◽  
Sonic Hedgehog ◽  
Subcutaneous Administration ◽  
Total Body Weight ◽  
Total Body

Effects of the teratogenic folic acid antagonist, 9-methyl pteroylglutamic acid, on hydroxyproline levels in fetal rat limbs

Development ◽  
1977 ◽  
Vol 41 (1) ◽  
pp. 289-294
Author(s):  
R. R. Schmidt ◽  
K. P. Chepenik ◽  
B. V. Paynton
Keyword(s):  
Body Weight ◽  
Folic Acid ◽  
Total Body Weight ◽  
Pregnant Rats ◽  
Skeletal Malformations ◽  
Fetal Rat ◽  
Pteroylglutamic Acid ◽  
Limb Malformations ◽  
Total Body ◽  
Rate Of Accumulation

Pregnant rats were subjected to either a folic-acid-deficient regimen that produces multiple congenital skeletal malformations, or a control folic-acid-supplemented regimen. Fetal limbs were extirpated on days 16 and 18 of gestation, pooled from each litter, homogenized, and aliquots set aside for hydroxyproline, protein and DNA determinations. We found that (1) the amount of protein recovered per treated limb was approximately half that of controls on both days, (2) the amount of protein recovered per treated or controlday-18 limb was twice that of a day-16 limb, (3) treated limbs constituted the same percentage of total body weight as in controls on day 16, but a smaller percentage than in controls on day 18, and (4) the concentration of hydroxyproline (μg/mg protein) was significantly less for treated limbs than for controls on day 18 of gestation. We noted also that: (1) lowest hydroxyproline concentrations were found in limbs from treated fetuses with gross limb malformations, (2) intermediate concentrations were found in limbs of treated fetuses not exhibiting gross limb malformations, and (3) highest concentrations were found in control limbs. We suggest that the treatment resulted in (1) a decreased rate of accumulation of protein in limbs prior to day 16, but not from day 16 to day 18, (2) a decreased rate of accumulation of some non-protein component(s) in treated limbs from day 16 to day 18, and (3) an altered collagen metabolism.

scholarly journals Growth and body weight of free-range reindeer in western Alaska

Rangifer ◽  
2000 ◽  
Vol 20 (2-3) ◽  
pp. 221 ◽  
Author(s):  
Greg L. Finstad ◽  
Alexander K. Prichard
Keyword(s):  
Body Weight ◽  
Growth Rates ◽  
Total Body Weight ◽  
Growth Patterns ◽  
Spatial And Temporal Variation ◽  
Adult Males ◽  
Body Weights ◽  
Total Body ◽  
Reproductive Females ◽  
Average Body

Total body weight of 9749 reindeer calves and 4798 adult reindeer were measured from 1984 to 1999 on the Seward Peninsula, western Alaska, USA. Growth rates of male and female calves, and annual growth patterns of adults were determined. Male calves grew faster than female calves. Reproductive females were lighter than non-reproductive females during summer but there was no effect of reproduction on average body weights the following winter. Adult males age 3-5 were heavier during summer than winter. Castrated males weighed the same as uncastrated males in summer, but were significantly heavier in winter, and did not display the large annual fluctuations in weight typical of reproductive males and females. Growth rates were higher and body weights greater in this herd than many other cir-cumpolar reindeer populations. We suggest these kinds of physiological indices should be used to monitor the possible effects of spatial and temporal variation in population density and to evaluate changes in herding practices.

scholarly journals SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Exercise Physiology ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Management Interventions ◽  
Co Morbidity ◽  
Total Body ◽  
Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

Water Relationships of Aphis Fabae Scop. During Tethered Flight

1961 ◽  
Vol 38 (1) ◽  
pp. 175-180
Author(s):  
A. J. COCKBAIN
Keyword(s):  
Body Weight ◽  
Relative Humidity ◽  
Water Loss ◽  
Total Body Weight ◽  
Aphis Fabae ◽  
Limiting Factor ◽  
Saturation Deficit ◽  
Tethered Flight ◽  
C 23 ◽  
Total Body

1. Water content varies from 64 to 73% of the total body weight and 72-76% of the fatless body weight of 24 hr. old unflown alatae of Aphis fabae. 2. Water loss during flight may be attributed to evaporation and excretion. A mean of 0.07 mg. water is lost per aphid during a 6 hr. tethered fligh a 25-26° C. and 57-82% R.H., corresponding to c. 9% body weight; at least 66% of the loss (c. 1% body weight/hr.) is by evaporation. 3. Excretion during fligh is not affected by relative humidity differences over the range 41-75% at 25%26° C., but the relative amounts of water lost during prolonged flight are inversely related to relative humidity, because of the effect of humidity on evaporation. 4. Proportion of water in he body does no change significantly during tethered fligh. Mean percentage water to total body weight increases from c. 68-69% during 6 hr.; mean percentage water to fatless body weight decreases from c. 74 to 73%. 5. Water loss is evidently not a limiting factor to fligh in atmospheres of saturation deficit less than c. 23 mm. Hg.

Vancomycin Removal during High-Volume Peritoneal Dialysis in Acute Kidney Injury Patients

2019 ◽  
Vol 39 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Daniela Ponce ◽  
Welder Zamoner ◽  
Fernanda Moreira Freitas ◽  
André Balbi ◽  
Linda Awdishu
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
High Volume ◽  
Total Body Weight ◽  
Empirical Treatment ◽  
Total Body

Studies on vancomycin pharmacokinetics in acute kidney injury (AKI) patients on high-volume peritoneal dialysis (HVPD) are lacking. We studied the pharmacokinetics of intravenous (IV) vancomycin in AKI patients treated by HVPD who received a prescribed single IV dose of vancomycin (15 - 20 mg/kg total body weight) to determine the extent of vancomycin removal and to establish vancomycin dosing guidelines for the empirical treatment of AKI patients receiving HVPD. The application of 18 mg/kg vancomycin every 48 - 72 hours in AKI patients undergoing HVPD was required to maintain therapeutic concentrations.

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