Intensive Care Unit Patients Clinical Trial
Official title:
PHASE ANGLE PROJECT
Critically ill patients feature a loss of fat-free mass (FFM) up to 440 g/day, which is
associated with increased morbidity and prolonged recovery. In several clinical conditions,
FFM or phase angle (PhA)derived from BIA have been associated with clinical outcome. However,
solid data to support this association in ICU patients are lacking. Only one retrospective
study of 51 ICU patients with acute respiratory failure correlated loss of active cell mass
with mortality. In a pilot study performed in 55 ICU patients, the investigators observed
that five kHz BIA PhA was significantly related to SOFA (r=0.38, P=0.03). The relation
between PhA and mortality remains to be determined in ICU patients.
Classic ICU validated severity scores (e.g. Acute Physiology and Chronic Health Evaluation
(APACHE), Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score
(SAPS)) and recent nutritional scores have been developed to foresee the clinical outcome of
ICU patients. Most of these scores are time consuming and suffer some degree of
discriminative power (i.e. APACHE II and SAPS II are not validated in cardiovascular surgery
patients).
PhA is reflecting intracellular status: altered intracellular water (ICW) to extracellular
water (ECW) distribution is suggested by low PhA. PhA measurement does not require anamnestic
parameters, body weight, and lab tests. It could easily, accurately and repeatedly measured
at bedside. PhA has been correlated with the disease prognosis in HIV infection,
hemodialysis, peritoneal dialysis, chronic renal failure and liver cirrhosis patients. These
studies suggest that PhA may be useful in determining increased risk of morbidity in the ICU.
Computerized tomography (CT) images targeted on the 3rd lumbar vertebrae (L3) could
accurately measure FFM13 and predict survival in cancer patients. Body composition evaluation
by CT presents great practical significance due to its routine ICU use in the initial
diagnosis or follow-up. The usefulness of measuring FFM with L3-targeted CT has never been
evaluated in ICU patients.
Therefore, the investigators aim to conduct an international multicentre prospective
observational study in ICU patients to assess the prognosis value of BIA PhA at admission,
and to compare the performances of BIA and L3-targeted CT for FFM measurement.
n/a
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