Fresenius Medical Care The BCM – Body Composition Monitor allows the detection of overhydration by determining the quantitative amount of excess fluid in. Fresenius Medical Care SUPPORT. For further information on the BCM – Body Composition Monitor, please see the following downloads: General Information. Download scientific diagram | The Fresenius’ Body Composition Monitor (BCM) is an example of multi-frequency Bio-impedance analysis technology. Picture.
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Fluid shifts from the limbs into the trunk feesenius as an apparent decrease in ECF when measured by whole-body techniques and shifts from the freseniue to the limbs as an increase in ECF Lundvall et al. Discussion Rationale for the need for flexible measurement protocols At a population level, it is becoming well accepted that using BCM as an aide in guiding fluid management in haemodialysis improves outcomes Onofriescu et al.
In principle the models that were generated and validated for the standard path can be employed with alternate paths. Accuracy of an eight-point tactile-electrode impedance method in the assessment of total body water. Data collection Healthy controls had height measured using a stadiometer and weight measured using calibrated scales.
Body Composition Monitor
Normal values for segmental bioimpedance spectroscopy in pediatric patients. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. Unlike controls, there was no difference in LTM or ATM between the sides Appendix 3despite the fact that vascular access is usually on the non-dominant side.
Making BCM measurements post-dialysis introduces a negligible bias to OH measurements but does increase measurement uncertainty, which should be accounted for when interpreting such data. Measurements of resistance, reactance and phase angle were made at the same 50 frequencies as in the standard BCM, for seventeen combinations of voltage and current see fig.
However, there is a lack of a sufficiently robust evidence-base for use of the BCM outside of standard protocols. If that is true, techniques for fluid management based on normalising calf ECF Seibert et al. National Center for Biotechnology InformationU. This would suggest that relatively more fluid is recruited from the legs than the upper body which is largely in agreement with previous work.
Body composition monitor (BCM)
For haemodialysis patients, the same model set up was used, only with the addition of measurement time pre- or post-dialysiswhich was added as a simple predictor variable for the models of LTM and ATM and as an interaction term for the model of OH, to allow assessment of ultrafiltration associated changes in fluid distributions between the paths. For measurements of R Esubstituting limbs and trunk paths does not significantly alter the overall path R Efor any of the whole body paths except the leg to leg path which is noticeably lower, consistent with results from the regression model.
Comorbidities present included acute coronary syndrome, heart failure, cerebrovascular disease, liver disease, peripheral vascular disease and smoking. The BCM validation literature also suggests that a bias is introduced into measurements of LTM and ATM when measurements are made immediately after dialysis but within 30 minutes this becomes non-significant.
To investigate the validity of post-dialysis measurements, the agreement between change in BCM-measured OH from the reference path and change in weight was assessed using Bland-Altman analysis. It would also have been interesting to extend the analysis to a group of haemodialysis patients who are defined as being prone to intradialytic hypotension IDHto investigate the relationship between fluid distributions, fluid dynamics and IDH.
Sum of segmental bioimpedance analysis during ultrafiltration and hemodialysis reduces sensitivity to changes in body position. Assessment of fat-free mass using bioelectrical impedance measurements of the human body.
Introduction Fluid management is an important part of care for haemodialysis patients Wizemann et al. Adjustments for age and sex in each model are given and also for measurement time in the models assessing LTM and ATM. Use of alternate paths The data from healthy controls show that there is no difference in BCM-measured OH between all the whole-body paths other than the foot-to-foot measurement, which had a difference of 0.
Study limitations The study was not powered to address the multiple comparisons made by the models – the sample size was based on comparisons between the two primary whole-body paths only.
Results Model results Patient characteristics can be seen in table 1. Conclusions In summary, these data helps BCM users make measurements and interpret results with greater confidence.
Effect fresenijs change in fluid distribution in segments in hemodialysis patients at different ultrafiltration rates on accuracy of whole body bioimpedance measurement. When considering post-dialysis measurements, it is accepted that haemodialysis induced changes in fluid distributions affect whole-body bioimpedance Zhu et al.
Validated alternative pathways would allow measurements to be made on patients who would have otherwise have been managed without BCM or managed based on poor quality data. European journal of clinical nutrition.
Bioimpedance-guided fluid management in maintenance hemodialysis: To present the data, results for a 60 year old female measured on the standard path acted as a reference standard path was taken as hand-to-foot on the dominant side of the body for controls and on and the contralateral side of the body to the most recently used vascular access VA for dialysis patients.
The data from healthy controls show that there is no difference in BCM-measured OH between all the whole-body paths other than the foot-to-foot measurement, which had a difference of 0.
freseniuss This is supported by looking at the segmental impedance data. The use of mixed-effects regression allowed a model to be built that could account for the repeated measures on an individual from the 8-lead BCM. Calf bioimpedance spectroscopy for determination of dry weight in hemodialysis patients: Bioelectrical impedance analysis–part I: Abbas et al Abbas et al.
Measurements on healthy controls suggest there is no significant difference in OH from any whole-body path other than across the legs. Author information Copyright and License information Disclaimer. Patient characteristics can be seen in table 1. For the models of LTM and ATM, including measurement time as an interaction term did not make a difference to the model, suggesting that the effect of measurement time on LTM and ATM was not different between the paths.
Using the segmental resistances in table 4the different path resistances can be built from the segments and referenced to the standard path figure 3. Considering LTM and ATM, there was a significant difference between the reference path and most other paths, apart from the cross measurements, including higher LTM and lower ATM in the dominant arm and in the hand-to-hand path as compared to the reference path.
Changes in hydration following haemodialysis estimated frexenius bioimpedance spectroscopy. The mortality risk of overhydration in haemodialysis patients. This characterises the individual differences in fluid status and body composition and accounts for this when describing the differences between the paths at the cohort level.