scholarly journals Bio-electric impedance as a tool to assess hydration in critically ill patients: an integrative review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Cristiano Corrêa Batista

Introduction: Assessing the hydration status of critically ill patients has been a difficult task over the decades. Determining how much fluid overload a patient has often helped in choosing a therapy. Methods such as bioelectrical impedance have been approached as a useful tool for this purpose. Objective: This study proposes to verify, through research in the literature, what is the real importance of the clinical use of bioelectrical impedance in the diagnosis of fluid overload in critically ill patients hospitalized in intensive care units. Methods: bibliographic search in the main scientific information databases: Scielo, PubMed, Cochrane, and Lilacs from January 2000 to July 2018. The selected languages were Spanish, Portuguese, and English. The keywords used were bioelectrical impedance, hydration, Intensive Care Unit, Intensive Care, bioelectrical impedance analysis, fluid balance, hydration overload. Results and Conclusion: The analysis of fluid overload in critically ill patients can be performed using multifrequency bioelectrical impedance. It is a useful tool in the diagnosis as well as in the quantification of water overload and, therefore, a corroborative method for clinical decision-making.

2017 ◽  
Vol 18 (3) ◽  
pp. 206-211 ◽  
Author(s):  
David P Hall ◽  
Helen Jordan ◽  
Shirjel Alam ◽  
Michael A Gillies

Introduction Focused echocardiography is widely used to assist clinical decision-making in critically ill patients. In the UK, the Focused Intensive Care Echo protocol is recommended by the Intensive Care Society to ensure consistency of approach and guarantee training standards. Concerns remain about the reliability of information attained by non-expert clinicians in focused echocardiography, particularly when this is used to alter clinical management. Methods A prospective, observational evaluation of 60 consecutive patients undergoing Focused Intensive Care Echo studies in a single ICU. Results A complete Focused Intensive Care Echo study was possible in 43/60 scans (72%) and new diagnostic information obtained following 41/60 scans (68%), which lead to a change of clinical management in 28/60 (47%) of cases. In 24/60 (40%) of cases, a full transthoracic study was subsequently undertaken by a fully accredited sonographer. There were no cases where the results from the full study contradicted those from the limited Focused Intensive Care Echo study; additional diagnostic information was attained following 68% of full studies. Conclusion Focused echocardiography using the Focused Intensive Care Echo protocol is feasible and clinically useful in a high proportion of ICU patients. However, many still require additional expert echocardiographic assessment. Focused echocardiography delivered by non-experts is clinically useful in this setting but its limitations must be understood and access to expert assessment should be available.


2020 ◽  
Vol 39 (6) ◽  
pp. 1809-1817 ◽  
Author(s):  
Willem G.P.M. Looijaard ◽  
Sandra N. Stapel ◽  
Ingeborg M. Dekker ◽  
Hanna Rusticus ◽  
Sharon Remmelzwaal ◽  
...  

2013 ◽  
Vol 40 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Nektaria Xirouchaki ◽  
Eumorfia Kondili ◽  
George Prinianakis ◽  
Polychronis Malliotakis ◽  
Dimitrios Georgopoulos

2015 ◽  
Vol 29 (4) ◽  
pp. 324-335 ◽  
Author(s):  
Daren K Heyland ◽  
Peter Dodek ◽  
Sangeeta Mehta ◽  
Deborah Cook ◽  
Allan Garland ◽  
...  

Background: Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. Aim: To describe family members’ perspectives about care provided to very elderly critically ill patients. Design: Multicenter, prospective, cohort study. Participants and setting: In total, 535 family members of patients aged 80 years or older admitted to 22 intensive care units for more than 24 h. Results: Family members reported that the “patient be comfortable and suffer as little as possible” was their most important value and “the belief that life should be preserved at all costs” was their least important value considered in making treatment decisions. Most family members (57.9%) preferred that life support be used for their family member, whereas 24.1% preferred comfort measures only, and 14.4% were unsure of their treatment preferences. Only 57.3% reported that a doctor had talked to them about treatment options for the patient. Overall, 29.7% of patients received life-sustaining treatments for more than 7 days and 50.3% of these died in hospital. Families were most satisfied with the skill and competency of nurses and least satisfied with being included and supported in the decision-making process and with their sense of control over the patient’s care. Conclusion: There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.


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