Abstract
Objective: To determine the relationship between bioimpedance analysis (BIA) parameters and central venous pressure (CVP), degree of edema, and cumulative fluid balance in patients with sepsis and septic shock in the Intensive Care Unit (ICU) of Dr. Wahidin Sudirohusodo Hospital.
Design: This study was an observational, analytical study with a cross-sectional design.
Setting: The study was conducted at the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia, from January to March 2025.
Patients: The study included 50 adult patients diagnosed with sepsis or septic shock who met the inclusion criteria and underwent BIA measurements.
Measurements: BIA parameters, including extracellular water (ECW), intracellular water (ICW), total body water (TBW), ECW/TBW ratio, phase angle, resistance, and reactance, were measured on day 3 after sepsis diagnosis. Clinical data included CVP, degree of edema, cumulative fluid balance, length of stay in the ICU, and in-hospital mortality.
Results: There was significant correlation between CVP and several BIA parameters, including ICW (r=-0.348, p=0.013), ECW (r=0.482, p<0.001), ECW/TBW ratio (r=0.747, p<0.001), phase angle (r=-0.499, p<0.001), resistance (r=-0.561, p<0.001), and reactance (r=-0.492, p<0.001). ECW and the ECW/TBW ratio were positively associated with the degree of edema, while phase angle and reactance showed negative associations (p<0.05). ICW, ECW/TBW ratio, phase angle, resistance, and reactance also showed significant associations with mortality (p<0.05). No significant correlation was found between any BIA parameter and cumulative fluid balance or length of stay in the ICU (p>0.05).
Conclusions: BIA parameters, especially low ICW, phase angle, resistance, and reactance, as well as high ECW and ECW/TBW ratio, were significantly associated with increased CVP, degree of edema, and mortality in sepsis and septic shock patients. These findings suggest that BIA could serve as a valuable tool in assessing fluid status and predicting clinical outcomes in critically ill patients.
Firmansyah Dahlan, Haizah Nurdin, Ari Santri Palinrungi, Syamsul Hilal Salam, Faisal Muchtar, Charles Wijaya Tan
